慢性乙型肝炎70例临床和病理诊断的相关性分析

Clinical and pathologic diagnostic study of 70 cases with Chronic Hepatitis B

目的探讨慢性乙型肝炎临床和病理诊断的相关性。方法将临床和病理资料完整的单一慢性乙型肝炎作为研究对象,比较其临床和病理资料。结果70例慢性乙型肝炎临床诊断均为轻度,HBVDNA均为阳性,与肝组织炎症活动度没有相关性,与纤维化程度呈负相关。肝组织炎症活动度与血清ALT、AST水平及A/G比值有相关性,随着炎症活动度的增加,血清ALT、AST水平上升,A/G比值下降;肝组织纤维化程度与血清ALT水平无明显相关性,与血清AST水平、A/G比值有相关性,纤维化程度越高,AST水平越高,A/G比值越低;ALB、CHE均为正常;PTa均>70%;TBiL异常者18例,均≤2倍ULN。结论慢性乙型肝炎病情较轻的阶段(轻度慢性乙型肝炎)血清ALT、AST水平的上升和A/G比值下降的诊断价值远大于血清ALB、CHE、PTa和TBIL的检查结果。

【Objective】To study the relevance of clinical and pathologic changes of patients with mild Chronic Hepatitis B（CHB）.【Methods】 Clinical and pathological data were collected from 70 cases with mild CHB.【Results】70 patients with mild CHB had a detectable viral load.There were no relevance between viral load and hepatic inflammation grade.There were relevance between viral load and hepatic fibrosis stage.There has relevance between ALT level,AST level or A/G ratio and hepatic inflammation grades or fibrosis stages.70 cases had a normal ALB and CHE level.The PTa of all cases was more than 70%.18 cases had abnormal TBIL,which were less than 2×ULN.【Conclusion】When compared to serum ALT level,AST level,and A/G ratio,the diagnostic value of serum ALB level,CHE level,PTa and TBiL for mild CHB were less significant.