乙、丙型肝炎病毒在慢性肝炎、肝硬化患者胃黏膜表达的临床研究

Clinical Significance of Hepatitis B and C Virus Antigen Expression in Gastric Mucosa of Patients with Chronic Liver Disease

目的 :探讨乙、丙型肝炎病毒 (HBV、HCV)的泛嗜性。方法 :选择慢性乙、丙型肝炎 (慢肝组 ) 2 8例、肝炎肝硬化 (肝硬化组 ) 44例 ,共 72例作为研究对象。受检者常规胃镜检查 ,取胃窦幽门周围 3cm以内活体组织两块 ,除普通病理检查外 ,分别做乙型肝炎病毒表面抗原 (HBsAg)、乙型肝炎病毒核心抗原 (HBcAg)、丙型肝炎病毒抗原 (HCVAg)免疫组化法检测。结果 :慢肝组有不同程度的胃黏膜慢性炎症者达 92 9% ( 2 6/2 8)、肝硬化组达95 5 % ( 4 2 /4 4) ,排除年龄影响因素外 ,慢肝组以单纯慢性炎症为多 ,而肝硬化组以伴萎缩和肠化者为多。慢肝组与肝硬化组患者分别有 5 3 6% ( 15 /2 8)、 81 8% ( 3 6/4 4)胃黏膜HBVAg阳性 ,其中HBsAg、HBcAg双阳性 3 1例。在5 1例患者胃黏膜HCVAg检测中有 3 3例 (占 64 7% )阳性表达、 66 7% ( 2 2 /3 3 )与HBVAg同时表达。肝硬化组HBVAg及HBsAg、HBcAg双阳性者均高于慢肝组 (P值均 <0 0 5 )。 结论 :HBV、HCV在慢性及肝硬化患者胃黏膜表达明显 ,应重视其在胃黏膜病变发病中的作用 。

Objective:To investigate the wide tropism of hepatitis B and C virus(HBV?HCV).Methods:Seventy-two patients were selected, among them 28 with chronic hepatitis B (chronic hepatitis B group), 44 with hepatitis B associated with cirrhosis (cirrhosis group); 30 patients with gastritis but without liver disease were used as control. In all patients diagnostic endoscopoy was performed. Two gastric biopsied were taken within 3 cm around the pylorus of gastric antra. Urease detection, HE, and immunohistochemical analysis of HBV and HCV antigen were conduted. Results:Different extent of chronic inflammation in cirrhosis group most patients with gland atrophy and intestinal metaplasia. The positivity of HBVAg in these two groups was 81.8%(36/44)?53.6%(15/28), respectively (P<0.05). The positivity of HCVAg in 51 patients with chronic liver disease is 64.7%(33/51).Conclusion: There are obvious expression of HBV antigen in the gastric mucosa of patients with chronic liver disease and cirrhosis. Its role in the pathogenesis of gastric mucosal lesion is the worthful subject to be further studied.