肝穿刺活检在乙肝病毒携带者中的应用

The Application of Liver Biopsy in Hepatic B Virus Carriers

目的:探讨乙肝病毒(HBV)携带者肝组织学变化。方法:用酶联免疫吸附(ELISA)分析方法检测HBsAg、HBeAg;用自动生化分析仪检测肝功能,用荧光定量PCR仪检测HBV DNA。同期对126例患者行肝活检,观察炎症(G0～G4)和纤维化分期(S0～S4),并与HBeAg状态和HBVDNA定量比较分析。结果:126例乙肝病毒携带者肝组织学炎症程度表现为G2(66.67%)>G1(25.40%)>G3(5.56%)>G0(2.38%),纤维化程度表现为S2(47.61%)>S1(31.75%)>S0(11.11%)>S3(7.94%)>S4(1.59%)。结论:HBV携带者者大部分肝组织仍有炎症和肝纤维化;另外HBeAg状态与肝组织学炎症活动和纤维化分期无相关性;HBV DNA≥1×105copies/mL的患者中≥G2占45.24%,HBV DNA水平与纤维化程度呈负相关趋势。

Objective： To investigate the change of hepatic tissue in hepatic B virus carriers. Methods： A total of 126 hepatitis B virus （HBV） carriers were taken with liver biopsy, synchronously. The serum level of HBsAg and HBeAg were measured by ELISA （enzyme linked immunosorbent assay） ; the liver function was examined by automatie biochemistry analyzer; the serum level of HBV DNA were detected by fluorescent quantitation PCR （ Polymer- ase Chain Reaction）, and The grading of inflammation （GO ~ G4 ） and the staging of liver fibrosis （SO - S4 ） were observed. Results： Inflammatory grading of liver tissues in 126 participants sh owed as following：G2 （66.67%） 〉 G1 （25.40%） 〉 G3 （5.56%） 〉 G0 （2.38%）, and staging of liver fibrosis results as S2 （47.61%） 〉 S1 （31.75% ） 〉 S0（ 11.11% ） 〉 S3 （7.94%） 〉 S4 （ 1.59% ）. Condusions： The majority of the HBV carriers have inflammation of liver tissues and liver fibrosis. In addition, there is no relativity between HBeAg index and liver tissues. In 45.24percent of the carriers whose HBV DNA level equals or is over 1 ×10^5eopies/mL, those inflammatory grading equals or is over G2, and there is a negative correlation tendency between HBV DNA level and the staging of liver fibrosis.