慢性乙型肝炎血清透明质酸和抗-HBe与肝组织病理的相关性

Study on Relationships between Pathological Changes and Hyaluronic Acid and Anti H Be in Patients with Chronic Hepatitis B

目的： 探讨慢性乙型肝炎血清透明质酸（ Ｈ Ａ） 和抗 Ｈ Ｂｅ 与肝组织病理改变的关系。方法：对１７０ 例慢性乙型肝炎患者进行肝活检，观察肝组织病理分级（ Ｇ） 和分期（ Ｓ） 情况，同时检测 Ｈ Ａ 及肝炎病毒标志物。结果：①血清 Ｈ Ａ 与肝组织病理分级和分期关系密切，随着病理分级和分期的升高， Ｈ Ａ 也逐渐升高， Ｇ４ 、 Ｓ４ 的血清 Ｈ Ａ 分别比 Ｇ１ 、 Ｓ１ 显著升高（ Ｐ ＜ ０００１） 。②肝组织病理分级、分期与血清抗 Ｈ Ｂｅ 的出现情况也密切相关， Ｇ４ 、 Ｓ４ 的抗 Ｈ Ｂｅ 阳性率分别比 Ｇ１ 、 Ｓ１ 显著升高（ Ｐ ＜ ００５） ；③抗 Ｈ Ｂｅ 阳性者中 Ｈ Ａ 值显著高于抗 Ｈ Ｂｅ 阴性病人（ Ｐ ＜ ０００１） 。结论： Ｈ Ａ 与抗 Ｈ Ｂｅ 有一定的相关性，在 Ｈ Ａ 显著升高或／ 和抗 Ｈ Ｂｅ 阳性的慢性乙型肝炎病人中，其肝组织的炎症、坏死及肝纤维化的程度较严重。

Objective : To observe the relationships between pathologicalchanges and hyaluronic acid ( H A) and an ti H Be in chronic hepatitis B. Methods : Liver biopsy was performed in patients with chronic hepatitis B. The histopatho logical grading ( G) and staging ( S) were carried out. Serum H Aand markers of viral hepatitis were tested in the cases . Results :① The histopathological grading and staging were closely correlated with H A. The mean of H Ain G4and S4 weresignificantly higherthan thatof G1 and S1respectively ( P < 0 001) . ② So did the anti H Be . The positive rates of anti H Be in G4 and S4 were significantly higherthan thatof G1 and S1respectively ( P < 0 05) . ③ The mean of H Ain caseswho developed anti H Be antibodies was significantly higherthan that ofthe cases who did not ( P < 0 001) . Conclu sions : H A was closely correlated with anti H Be . The higher severity ofthe inflammatory ,necrosis and fibrosis of hepatictissue were observed in chronic hepatitis Bpatients with anti H Be positive or/and higher H A.