120例慢性乙型肝炎患者肝组织病理与临床生化检查相关性分析研究

Study on the Correlation between Liver Histopathology and Clinical Biochemical Examination in 120 Patients with Chronic Hepatitis B

目的对慢性乙型肝炎患者肝组织病理与临床诊断符合性及其与某些临床生化指标的之间的相关性进行分析与研究。方法选取2015年4月—2017年4月到该院接受治疗的慢性乙型肝炎患者120例为研究对象,采集患者的肝穿刺组织病理标本,并实施统计学分析。结果慢性乙型肝炎患者的病理诊断与临床诊断之间存在较大差异。肝组织炎症分级:G1~G4的GGT分别为(48.2±31.2)、(55.8±49.5)、(98.6±58.1)、(195.6±113.5)U/L;G1~G4的AST分别为(57.2±43.2)、(69.8±50.5)、(128.5±93.6)、(219.6±186.8)U/L;G1~G4的ALT分别为(81.3±54.5)、(103.5±77.5)、(198.3±118.9)、(381.6±230.1)U/L;G1~G4的TBI分别为(15.3±8.2)、(18.5±10.7)、(23.2±10.4)、(47.2±56.3)μmol/L;G1~G4的PTA分别为(78.8±13.6)%、(79.2±16.8)%、(70.2±16.7)%、(51.8±18.2)%;G1~G4的ALB分别为(45.4±3.8)、(39.5±4.8)、(37.9±5.4)、(37.5±6.5)g/L。纤维分期:S1~S4的GGT分别为(46.7±33.4)、(53.4±45.2)、(101.3±50.3)、(195.3±110.4)U/L;S1~S4的AST分别为(56.8±49.7)、(68.3±50.2)、(109.6±98.7)、(210.5±180.6)U/L;S1~S4的ALT分别为(90.4±78.2)、(99.6±70.4)、(190.6±101.4)、(378.3±220.5)U/L;S1~S4的TBI分别为(16.2±8.7)、(18.6±10.2)、(22.6±87.4)、(46.4±55.7)μmol/L;S1~S4的PTA分别为(78.8±16.8)%、(76.2±16.4)%、(70.3±14.5)%、(51.8±17.7)%;S1~S4的ALB分别为(45.2±5.5)、(38.7±4.2)、(37.6±4.8)、(37.2±6.3)g/L。结论慢性乙型肝炎患者肝组织病理与临床诊断存在较大差异,应尽快实行肝穿刺活检,以便尽快进行早期治疗与诊断,这样方能有效的改善患者的生活质量。

Objective This p ap e r tries to study th e re la t io n sh ip b etwe en th e path o lo gical an d cl in ic a l d iagnosis of ch ro n ic hepat i t is B and its correlation with some cl inical biochemical indexes . Methods 120 c a se s of ch ro n ic h ep a t i t is B p atien ts treated in this hospi tal from Apr il 2015 to Apr il 2017 were selected as the subjects. The histopathological specimens of liver biopsy were collected and were stat is t ical ly analyzed. Results T he re was a sign if ic an t differenc e b etwe en pathologic d iag n o -sis and cl inical diagnosis in patients with chronic hepat i t is B. The GGT of G1？ G4 were （4 8 .2±3 1.2） , （55.8±49.5） , （9 8 .6土 58.1）, （195.6±113.5）U/L respec tiv e ly . The AST of G1？ G4 was （5 7 .2±4 3 .2 ）, （6 9 .8±5 0.5）, （1 2 8.5± 93 .6 ）, （21 9.6±18 6 .8 ）U/L r e -spectively. The ALT of G1？ G4 were （8 1 .3 ± 5 4 .5 ）,（ 1 0 3 .5 ± 7 7 .5 ）,（ 1 9 8 .3 ± 1 1 8 .9 ）,（ 3 81 .6±2 3 0.1）U/L ; an d th e TBI of G 1- G4 was （15.3±8.2）, （18.5±10.7） , （23.2±10.4） , （47.2±56.3）μmol/L re sp ec tiv e ly . T h e PTA of G 1-G4 were （7 8 .8±1 3.6）%s （7 9 .2± 16.8）%.（ 70.2±16.7）%,（ 51.8±18.2）% T h e ALB of G1- G4 were （4 5 .4±3 .8 ）,（ 3 9 .5± 4 .8 ）,（ 3 7 .9± 5.4） , （37.5±6.5）g/L. F ib e r staging： the GGT of S1？ S4 were （46 .7±3 3.4） , （5 3 .4±4 5.2） , （1 0 1.3± 50 .3 ）, （195.3±110.4）U/L; th e AST of S 1？ S4 were （5 6 .8± 4 9 .7）, （68.3 ±50.2）, （109.6±98.7） , （210.5 ±180.6） U/L; the ALT of S1 ？ S4 were （9 0 .4 ± 7 8 .2 ） , （9 9 .6± 7 0 .4 ） , （1 9 0 .6± 1 0 1 .4 ） , （378.3 土 220.5） U/L; the TBI of S1？ S4 were （16.2±8.7）, （1 8 .6±1 0.2） , （2 2 .6±8 7.4） , （4 6 .4 ± 5 5 .7 ）mol/L; th e PTA of S1- S4 were （78.8± 16.8）%, （76.2±16.4）%, （70.3±14.5）%, （51.8±17.7）%; the ALB of S1？ S4 were （45.2±5.5）, （38.7±4.2）, （37.6±4.8）, （37.2±6.3）g/L.Conclusion T he path o lo gical and c l in ic a l diagnosis of ch ro n ic h ep a t i t is B is d ifferent , so live r biopsy should be c a r r ied out as soon as pos sible, so that early treatment and diagnosis can be car r ied out immediately, and the quality of life can be im-proved effectively.