宜宾地区ALT2×ULN慢性HBV感染者肝组织病理分析.docVIP

宜宾地区ALT2×ULN慢性HBV感染者肝组织病理分析 　　【摘要】 目的：分析宜宾地区丙氨酸氨基转移酶（ALT）2×正常值上限（ULN）慢性HBV感染者的肝组织病理学特征。方法：选择97例宜宾地区ALT2×ULN慢性HBV感染者进行肝穿刺活检，并对不同炎症分级和纤维化分期患者的血常规、凝血酶原时间（PT）、肝功能和HBV-DNA定量等情况进行比较。结果：97例患者中，40.2%患者炎症分级≥G2，10.3%患者纤维化分期≥S2，G≥2组患者的ALT水平高于G2组；S≥2组患者的构成比随着年龄的增加而升高；血清HBV-DNA水平和HBeAg状态与肝脏的组织学改变无关。结论：对ALT2×ULN慢性HBV感染患者应考虑进行肝穿刺活检，特别是那些年龄≥40岁且ALT≥50 U/L者。 　　【关键词】 乙型肝炎； 慢性； 丙氨酸氨基转移酶； 病理学； 临床 　　Pathological Analysis of Liver Tissues in Chronic Hepatitis B Virus Infected Patients with Serum Alanine Transaminase Less than Two Times the Upper Limit of Normal in Yibin Area/YAO Ling，MAO Hai-ying，KANG Tao，et al.//Medical Innovation of China，2016，13（18）：145-148 　　【Abstract】 Objective：To analyze the pathological features of liver tissues in chronic hepatitis B virus（HBV） infected patients with serum alanine transaminase（ALT） less than two times the upper limit of normal（ULN） in Yibin area.Method：Liver biopsies were performed in 97 chronic HBV infected patients with serum ALT less than 2×ULN in Yibin area.The differences about blood routine examination，prothrombin time，liver function，HBV-DNA level，and so on were compared according to the grade of inflammation or the stage of fibrosis.Result：Among 97 patients，40.2% of them were found with inflammation graded above G2，10.3% of them were found with fibrosis staging above S2.The serum ALT levels in patients with inflammation graded above G2 were higher than those with inflammation graded below G2.The constituent ratios of those patients with fibrosis staging above S2 increased with age.Neither HBV-DNA levels nor HBeAg statuses were related to the histological changes in liver.Conclusion：Liver biopsies should be considered in chronic HBV infected patients with serum ALT less than 2×ULN，especially those older than 40 year and with serum ALT greater than or equal to 50 U/L. 　　【Key words】 Hepatitis B； Chronic； Alanine aminotransferase； Pathology； Clinical 　　First-author’s address：The Second People’s Hospital of Yibin City，Yibin 644000，China