慢性HBV感染患者血清ALT/AST及LSM值与肝组织病理改变的关系探究

Relationship between serum ALT/AST,LSM and pathological changes of liver tissues in patients with chronic HBV infection

目的探究慢性乙型肝炎病毒(HBV)感染患者血清丙氨酸氨基转移酶/天冬氨酸转氨酶(ALT/AST)比值及肝硬度(LSM)值与肝组织病理改变的关系。方法选取2020年4月-2022年5月贺州市人民医院收治的78例HBV感染患者为HBV组,选取同期78例肝组织正常者为对照组。采用生化分析仪检测血清ALT、AST浓度,采用瞬时弹性扫描仪检测LSM值,比较HBV组和对照组血清ALT、AST、ALT/AST比值及LSM值;对慢性HBV感染患者实施肝穿刺病理检查,评估组织炎症分级(G1-G4)和纤维化分期(S1-S4),比较HBV组患者不同G分级、S分期血清ALT、AST、ALT/AST比值及LSM值;分析慢性HBV感染患者血清ALT/AST及LSM值与肝组织病理改变的相关性。结果HBV组血清ALT、AST、ALT/AST比值及LSM值较对照组均显著升高,差异具有显著性(P<0.05);重度炎症组和重度纤维化组的HBV患者血清ALT、AST和LSM值均升高,且高于轻度炎症组和轻度纤维化组(P<0.05)。比较HBV组不同G分级、S分期的ALT/AST比值,轻度炎症组和轻度纤维化组ALT/AST比值均大于重度炎症组和重度纤维化组(P<0.05)。Pearson相关性分析结果显示,ALT/AST比值与慢性HBV患者肝组织炎症分级和纤维化程度呈负相关(r=-0.041,r=-0.420,P<0.05)。LSM值与慢性乙肝患者肝组织纤维化和炎症程度呈高度正相关(r=0.778,r=0.800,P<0.05)。结论慢性HBV感染患者血清ALT、AST水平明显升高,血清ALT/AST及LSM值与肝组织病理变化相关,有助于慢性HBV感染的病情进展评估。

Objective To explore the relationship between serum alanine aminotransferase/aspartate aminotransferase(ALT/AST)ratio,liver stiffness measurement(LSM)and pathological changes of liver tissues in patients with chronic hepatitis B virus(HBV)infection.Methods A total of 78 patients with HBV infection admitted to the hospital were enrolled as HBV group between April 2020 and May 2022,while 78 patients with normal liver tissues during the same period were enrolled as control group.The levels of serum ALT and AST were detected by biochemical analyzer.LSM was detected by transient Fibroscan.The serum ALT,AST,ALT/AST ratio and LSM were compared between HBV group and control group.The patients with chronic HBV infection underwent liver biopsy to evaluate tissue inflammation grading(G1-G4)and fibrosis staging(S1-S4).The serum ALT,AST,ALT/AST ratio and LSM in patients with different G grading and S staging in HBV group were compared.The correlation between serum ALT/AST,LSM and pathological changes of liver tissues was analyzed.Results The serum ALT,AST,ALT/AST and LSM in HBV group were significantly higher than those in control group(P<0.05).The serum ALT,AST and LSM in severe inflammation group and severe fibrosis group were all increased,higher than those in mild inflammation group and mild fibrosis group(P<0.05).The ALT/AST ratios of different G grades and S stages in HBV group were compared.The ALT/AST ratios of mild inflammation group and mild fiber group were higher than those of severe inflammation group and severe fiber group(P<0.05).The results of Pearson correlation analysis showed that ALT/AST ratio was negatively correlated with inflammation grading and fibrosis degree(r=-0.041,r=-0.420,P<0.05),while LSM was highly positively correlated with fibrosis degree and inflammation grading(r=0.778,r=0.800,P<0.05).Conclusion The levels of serum ALT and AST significantly increase in patients with chronic HBV infection.The serum ALT/AST and LSM are related to pathological changes of liver tissues,which are beneficial to evaluate progression of chronic HBV infection.