慢性HBV感染者肝脏病理改变的研究进展

The research in liver tissue pathology of chronic HBV infection patients

肝组织病理学检查是反映慢性HBV感染者肝脏病变程度最直接的指标。通常认为血清转氨酶正常或轻度异常[<2×正常值上限(ULN)]的慢性HBV感染者肝脏病变程度轻微,然而近年来多数学者发现部分转氨酶<2×ULN的患者肝脏病理改变程度严重。对慢性HBV感染者临床特征与肝脏肝组织病理改变程度的关系进行论述,系统地了解了转氨酶<2×ULN慢性HBV感染者的病理与临床特征,并认为年龄、性别、HBeAg状态、HBV DNA及ALT水平等与其均具有一定的关系,监测这些因素有助于更全面地明确慢性HBV感染者肝脏病理改变程度。

Histopathological examination of the liver is the most direct method for evaluating the pathological changes of the liver in patients with chronic hepatitis B virus （HBV） infection. Generally, the patients with chronic HBV infection who show normal or slightly elevated serum alanine transaminase （ALT） levels （ 〈 2× ULN ） are considered to have mild hepatic fibrosis or inflammation. However, in recent years, many scholars have found that some patients with serum ALT levels below 2 × ULN have severe pathological changes. The relationship between clinical features and pathological changes of the liver in patients with chronic HBV infection is reviewed, and the pathological and clinical features of chronic HBV infection patients with serum ALT levels below 2 x ULN are understood systenlatically. Age, sex, HBeAg status, HBV DNA level, and ALT level are considered to have certain relationship with these features. Monitoring of these factors is helpful for comprehensive evaluation of pathological changes of the liver in patients with chronic HBV infection.