71例慢性乙型肝炎患者肝活检病理学分析

Analysis of pathological diagnosis of percutaneous liver biopsy in 71 patients with chronic hepatitis B

目的探讨肝穿刺活检对慢性乙型肝炎诊断的临床意义。方法对71例慢性乙型肝炎患者行经皮肝穿刺活体组织检查,分析临床诊断与病理学诊断的准确性。结果在71例慢性乙型肝炎患者中,病理学诊断为G1为9.9%,G2和G3为59%,而G4为31%,诊断纤维化分期S1～S4分别为29%、25%、13%和32%,而临床诊断的灵敏度、阳性似然比、阳性预测值、Youden指数均偏低。结论临床诊断慢性乙型肝炎病情程度的分度还不够准确,肝穿刺活检对诊断、治疗和预后判断等仍有着极其重要的意义。

Objective To explore the clinical significance of liver biopsy in patients with chronic hepatitis B.Methods The percutaneous liver biopsies were operated in 71 patients with CHB and the clinical diagnosis were assessed based on the pathological diagnosis.Results In the 71 patients with CHB,G1 to G4 were pathologically found in 9.9%,35%,24% and 31%,and S1 to S4 were 29%,25%,13% and 32%,respectively,while the sensitivity,specificity and accuracy of clinical diagnosis were relatively lower.Conclusion The percutaneous liver biopsy is vital to the diagnosis,treatment and prognosis of patients with chronic hepatitis B.