90例慢性乙肝患者ALT、HBVDNA水平与肝脏病理的关系

Study on Relationship Between Hepatic Pathohistology and ALT and Serum HBVDNA in 90 Patients with Chronic Hepatitis B

目的：探讨慢性乙型肝炎患者血清谷丙转氨酶（ALT）、HBVDNA水平与肝脏病理的关系。方法：90例慢性乙肝患者接受彩色B超指引下经皮肝穿刺活检术,病理切片由病理科医生读片,肝穿前完善血清谷丙转氨酶（ALT）及HBVDNA检测,并与肝脏组织炎症及纤维化程度相比较。结果：90例患者均存在不同程度的肝脏炎症及纤维化,异常率100%。肝脏炎症在G2~G4的共72例（占80.0%）,其中ALT〈2ULN的共38例（占52.8%）,ALT≥2ULN的共34例（占47.2%）,两组在肝脏炎症程度方面比较,差异无显著性意义（XG2=3.942,PG〉0.05）。纤维化在S2-4的患者工有67例（占74.4%）,其中ALT〈2ULN的共36例（占53.7%）,ALT≥2ULN的共31例（占46.3%）,两组在肝脏纤维化程度方面比较,差异无显著性意义（XS2=2.151,PS〉0.5）。血清HBVDNA水平与肝脏不同炎症及纤维化程度之间均没有显著性差异（P〉0.05）。结论：肝脏病理检查可直接反应肝组织炎症及纤维化程度,并作为慢性肝炎患者是否需要抗病毒治疗的依据。

Objective：To investigate the relationship between liver pathological changes and liver function transaminase（ALT） or serum HBVDNA level in patients with chronic hepatitis B（CHB）.Methods：90 cases chronic hepatitis B（CHB） receive liver biopsy guided by color B-ultrasound,the biopsy slices were read by Pathology Doctors.The serum transaminase（ALT） and the level of HBVDNA were detected and compared to biopsy.Results：90 cases of patients with varying degrees of liver inflammation and fibrosis,abnormal rate of 100%.72 cases out of 90 patients（80.0%） were G2-G4 with inpiammation.38 cases（52.8%） in ALT2ULN groups and 34 cases（47.2%） in ALT≥2ULN group.There were no significant differences in nflammation between two groups（XG2=3.942,PG0.05）.67 cases out of 90 patients（74.4%） were S2-S4 with fibrosis.36 cases（53.7%） in ALT2ULN groups and 31 cases（46.3%） in ALT≥2ULN group.There were no significant differences in fibrosis between two groups（XG2=2.151,PS0.5）.The level of serum HBVDNA no correlation with the degree of liver inflammation and fibrosis（P0.05）.Conclusion：The liver biopsy may be a direct response to liver inflammation and fibrosis,and may serve as reference indexes of anti-virus treatment for patients with chronic hepatitis B.