性别和年龄对慢性乙型肝炎肝组织病理学状态的判别价值

Value of sex and age for discriminating hepatic pathological status in patients with chronic hepatitis B

目的探讨性别和年龄判别慢性乙型肝炎肝组织炎症活动度和纤维化程度的效能。方法选择慢性乙型肝炎患者491例,其中病理学诊断为G0、G1、G2、G3、G4的患者分别为0,136,203,140,12例,诊断为S0、S1、S2、S3、S4的患者分别为34,96,138,105,118例。统计分析采用SPSS 13.0软件。肝组织不同病理学分级和分期患者性别比例和平均年龄之间的比较分别采用2检验和单因素方差分析;性别和年龄判别肝组织不同病理学分级和分期的评价采用Bayes逐步判别分析。结果性别比例在不同病理学分级和分期患者间均无显著性差异(P均>0.05),平均年龄在不同病理学分级和分期患者间均有显著性差异(P均<0.01)。符合模型纳入变量、进入判别函数的指标只有年龄。根据判别不同病理学分级和分期的判别函数,当患者年龄≤33岁和≥44岁时,其肝组织病理学分级分别被判别为G1和G4的可能性较大;当患者年龄≤33岁和≥40岁时,其肝组织病理学分期分别被判别为S0和S4的可能性较大。结论性别对慢性乙型肝炎肝组织病理学状态没有判别意义,年龄对慢性乙型肝炎肝组织炎症活动度和纤维化程度有一定判别价值。

Objective It is to approach the powers of sex and age for discriminating the hepatic inflammatory activities and fibrotic levels in patients with chronic hepatitis B.Methods Four hundred and ninety-one patients with chronic hepatitis B were chosen,in which 0 case,136 cases,203 cases,140 cases and 12 cases were pathologically diagnosed as G0,G1,G2,G3 and G4 respectively;and 34 cases,96 cases,138 cases,105 cases and 118 cases were pathologically diagnosed as S0,S1,S2,S3 and S4 respectively.SPSS 13.0 software was used for statistical analyses.2 tests and one-way ANOVA were used for comparison of the sex ratios and the mean ages in patients with different pathological grading and staging respectively.Bayes stepwise discriminant analysis was used for appraising the powers of sex and age for discriminating the hepatic pathological grading and staging.Results There were no significant differences on the sex ratios in patients with different pathological grading and staging（all P0.05）,and there were significant differences on the mean ages in patients with different pathological grading and staging（all P0.01）.Only age entered the discriminant functions according to the entry criteria of the independents.According to the discriminant functions for discriminating different pathological grading and staging,the patients had higher probability of G1 and G4 when the age of the patients was not more than 33 a and not less than 44 a respectively;and had higher probability of S0 and S4 when the age of the patients was not more than 33 a and not less than 40 a respectively.Conclusion Sex has little significance for discriminating the hepatic pathological status,and age has some value for discriminating the hepatic inflammatory activities and fibrotic levels in patient with chronic hepatitis B.