ALT正常HBeAg阳性HBV感染者28例血清HBVDNA水平与肝脏病理关系的分析

THE LEVEL OF SERUM HBV DNA AND HEPATIC PATHOLOGY OF 28 CASES WITH HBEAG-POSITIVE HEPATITIS B VIRUS INFECTION CONCOMITANCE NORMAL SERUM ALT

目的探讨ALT正常的HBeAg阳性HBV感染者血清HBVDNA水平与肝脏病理的关系,为临床抗病毒治疗提供最佳时机。方法应用实时荧光定量聚合酶链反应法(PCR)对28例ALT正常的HBeAg阳性HBV感染者进行定量检测,并与同期肝脏活检病理结果进行对比分析。结果 ALT正常的HBeAg阳性HBV感染者血清HBVDNA水平与肝脏病理炎症活动度分级(G)及纤维化程度分期(S)无明显相关性。结论对ALT正常的HBeAg阳性HBV感染者应尽可能早行肝脏活组织病理检查,并依据其炎症活动度分级(G)及纤维化程度分期(S),而不应根据其血清HBVDNA水平的高低决定治疗时机。

Objective To investigate the level of serum HBV DNA and hepatic pathology patients with HBeAg- positive hepatitis B virus （HBV）infection concomitance normal serum ALT,and find optimal time for clinical antiviral therapy. Methods The real- time fluorescent quantization PCR was used to determine the serum HBV DNA level of 28 cases of HBeAg - positive hepatitis B virus infection with normal serum ALT patients. The relation of serum HBV DNA level and homeochronous hepatic pathology, which was obtained by liver biopsy, was analyzed. Results There were no significant correlation on serum HBV DNA level and the Grade inflammatory activity of liver pathology and the Stage of liver fibrosis in HBeAg- positive hepatitis B virus infector with normal serum ALT. Conclusions The liver biopsy should be early taken in the HBeAg- positive hepatitis B virus infection with normal serum ALT patients, and the optimal time for clinical antiviral therapy is determined by the Grade inflammatory activity of liver pathology and the Stage of liver fibrosis, rather than the serum HBV DNA level.