本文關(guān)鍵詞： 肝炎 乙型 慢性 肝臟病理 HBe抗原　出處：《實(shí)用醫(yī)學(xué)雜志》2015年16期 　論文類型：期刊論文

【摘要】：目的:探討HBe Ag陰性的慢性乙型肝炎(CHB)患者的肝臟病理特點(diǎn)及其相關(guān)因素。方法:選擇134例符合抗病毒治療條件的HBe Ag陰性的CHB患者,行肝穿刺活檢,常規(guī)蘇木素-伊紅染色及嗜銀染色后,采用改良的Knodell HAI評(píng)分系統(tǒng)進(jìn)行病理分析,并檢測(cè)患者血清中丙氨酸氨基轉(zhuǎn)移酶(ALT)、HBV DNA、乙型肝炎血清標(biāo)志物以及乙型肝炎病毒基因型。均數(shù)比較采用t檢驗(yàn)和方差分析,非參統(tǒng)計(jì)采用Kruskal-Wallis檢驗(yàn),用多元線性回歸方法分析與肝臟炎癥活動(dòng)和纖維化相關(guān)的因素。結(jié)果 :134例HBe Ag陰性CHB患者炎癥活動(dòng)指數(shù)(HAI)按輕度(4~8分)、中度(9~12)和重度(13~18)炎癥分組,3組中病例數(shù)分別為36例(26.9%)、35例(26.1%)、63例(47.0%)。纖維化評(píng)分3分和≥3分的病例數(shù)分別為25例(18.7%)和109例(81.3%)�；颊哐錋LT水平和肝臟纖維化是肝臟炎癥活動(dòng)度的相關(guān)因素(t=6.687,P0.01;t=3.478,P0.01);而患者年齡和肝臟炎癥活動(dòng)度是肝臟纖維化的相關(guān)因素(t=3.587,P0.01;t=7.136,P0.01)。患者性別、乙型肝炎病毒載量、乙型肝炎病毒基因型和HBe Ab狀態(tài)與肝臟病理改變無明顯相關(guān)。結(jié)論:本研究HBe Ag陰性的CHB患者中,肝臟病理改變以中、重度肝炎居多,患者血清ALT水平越高,肝臟炎癥活動(dòng)越重,患者年齡越大,肝臟纖維化程度越重。
[Abstract]:Objective: to study the HBe Ag negative chronic hepatitis B (CHB). Methods: 134 patients with HBe Ag negative CHB who met the condition of antiviral therapy were selected. Liver biopsy, routine hematoxylin eosin staining and argyrophilic staining were performed, and pathological analysis was performed with the improved Knodell HAI scoring system. The HBV DNA, HBV markers and HBV genotypes in serum of patients with alanine aminotransferase (alt) were detected. T test and ANOVA were used to compare the mean values. Kruskal-Wallis test was used for nonparametric statistics. Multivariate linear regression method was used to analyze the factors related to liver inflammation and fibrosis. Results the inflammatory activity index (HBe) of 134patients with HBe Ag negative CHB was 4 ~ 8 points. The number of cases in the 3 groups were 36 cases and 35 cases were 26. 1% respectively. The number of cases with fibrosis score of 3 and 鈮，

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