抗病毒治疗对慢性乙型肝炎患者肝组织病理的影响

The effect of antiviral therapy on liver histology in chronic hepatitis B patients

目的通过对慢性乙型肝炎患者抗病毒治疗前后进行肝组织病理检查,分析其抗病毒治疗效果。方法收集2005年8月-2012年10月治疗的慢性乙型肝炎29例,在其抗病毒治疗48周前后进行肝穿刺活检检查,比较治疗前后变化。结果与治疗前相比,完全应答组无论炎症或纤维化程度均明显改善(P<0.01),部分应答组炎症程度得到改善(P<0.05),纤维化程度则无明显改变(P>0.05),而无应答组治疗前后相比,炎症及纤维化程度均无明显改变(P>0.05)。结论无论予干扰素或核苷(酸)类似物抗病毒治疗,获得病毒学完全应答均可明显改善肝脏炎症、纤维化程度。

Objective To evaluate the efficacy of antiviral therapy in chronic hepatitis B （ CHB） patients by histologically ex-amination of liver before and after therapy .Methods 29 CHB patients between August 2005 and October 2012 were received biopsy before and after antiviral treatment of 48 weeks,and the histological improvement was evaluated .Results Compared with pretreatment , both inflammation grade and fibrosis stage were significantly improved in complete response group （P〈0.01）.Through compared with pretreatment,only inflammation grade in part-response group were improved significantly （P〈0.05）,and fibrosis stage was no obvious change（P〉0.05）.There was no obvious change of inflammation grade and fibrosis stage in non-response group（P〉0.05）.Conclu-sion CHB patients treated with interferon or nucleoside analogues （ acid） achieved virological complete response and can greatly im-prove the degree of liver inflammation and fibrosis .