需抗病毒治疗的慢性HBV感染者的无创初筛——附134例肝活检组织病理报告分析

Non-invasive prescreening of patients with chronic hepatitis B virus infection and needed antiviral management:An analysis of the hepatic tissue pathology report of 134 cases

目的:探讨无创筛选抗病毒治疗患者的模型。方法:通过对134例肝穿活检患者肝组织病理学炎症和纤维化程度与临床理化指标的相关性分析,找到两个较佳指标,建立评分模型。结果:与肝脏炎症程度相关性最好的指标是丙氨酸转氨酶(ALT,r=0.499,P<0.01),与纤维化程度相关性最好的指标是B超(r=0.517,P<0.01),结合评分,可将部分需要抗病毒治疗的患者从中筛选出来,使46.3%的患者避免肝穿活检。结论:ALT结合B超可适用于抗病毒治疗患者的初筛。

Objective：To establish a non-invasive model of prescreening the patients with chronic hepatitis B virus（HBV） infection and needed antiviral management.Methods：The clinical data were collected and liver biopsies and hepatic tissue pathology checking were done in 134 patients with chronic HBV infection.The correlation between the degree of hepatic fibrosis,grade of liver inflammation and clinical indexes,including result of B-type ultrasonic inspection,serum markers,the counts of blood cells,were analyzed respectively,and a simple scoring system was established at the same time.Results：Alanine transarninase（ALT） was the best index positively correlated with the liver inflammation（r=0.499,P0.01）,and result of B-type ultrasonic inspection was the best one done with the grade of hepatic fibrosis（r=0.517,P0.01）too.Combining the score of ALT and result of B-type ultrasonic inspection,46.3% of all 134 patients who needed antiviral therapy were screen out without a liver biopsy.Conclusion：ALT and result of B-type ultrasonic inspection can be applied to non-invasive prescreening of patients needed antiviral management of chronic hepatitis B virus infection.