肝活检对HBV携带者的诊断意义

The histopathological manifestations in individuals with hepatitis B viral carriers

目的探讨肝活检对HBV携带者的诊断意义。方法回顾性分析134例HBV携带者,在B超引导下行1秒钟快速肝穿刺活检术,行肝组织病理学检查。结果在134例患者中,仅2例(1.49%)肝组织病理学检查完全正常(G0S0);在105例HBV DNA≥105copies/ml(或HBeAg阴性者HBV DNA≥104copies/ml)的HBV携带者中,肝组织炎症活动度≥G2者80例(76.19%),即可实施抗病毒治疗;在100例HBeAg(+)与34例HBeAg(-)感染者,肝组织炎症活动度和纤维化程度比较无明显统计学差异(P=0.308);在不同肝组织炎症活动度和纤维化程度感染者,HBV DNA载量无明显的统计学差异(P=0.557),HBV DNA≥107copies/ml与HBV DNA<107copies/ml感染者比,肝组织炎症活动度和纤维化程度存在统计学差异(P=0.007,P=0.001)。结论对于慢性HBV携带者,应及时进行肝组织活检。

Objective The aim of this study was to investigate the clinic significance of liver biopsy in asymptomatic chronic hepatitis B virus carriers. Methods 134 individuals with chronic hepatitis B viral carriers received the liver biopsy. Results Liver biopsies showed hepatic necrosis inflammation and fibrosis in 1.49%（2/ 134）without any change;Among 105 patients who met the HBV DNA≥10^5 copies/ml（or in HBeAg negative patients was≥10^4 copies/ml）,there were 80 cases whose liver inflammation≥G2;Between 100 patients with HBeAg （＋）and 34 patients with HBeAg （-）,there was no significantly statistical difference in their liver inflammation and fibrosis （P=0.308）;the hepatic necrosis inflammation and fibrosis between group with HBV DNA〈10^7copies/ml and those with HBV DNA≥10^7copies/ml were statistically different（P=-0.007,P=0.001）. Conclusions The liver biopsy should be done in chronic hepatitis B carriers in time.