本文選題：肝炎　切入點(diǎn)：乙型　出處：《安徽醫(yī)科大學(xué)》2013年碩士論文　論文類型：學(xué)位論文

【摘要】：目的： 通過對(duì)慢性乙型肝炎病毒感染者行肝組織學(xué)檢查，分析慢性乙型肝炎病毒感染者肝臟組織學(xué)影響因素。 方法: 本研究收集了從2010年3月到2011年8月在安徽醫(yī)科大學(xué)第一附屬醫(yī)院感染科住院并進(jìn)行肝組織病理學(xué)檢查的129例慢性HBV感染者資料。調(diào)查入選時(shí)患者一般情況、肝功能、乙肝病毒學(xué)標(biāo)志物、乙肝病毒復(fù)制量等。所有病例均在B超引導(dǎo)下進(jìn)行肝穿刺病理活檢，并進(jìn)行肝組織炎癥活動(dòng)度(G)分度及纖維化程度分期(S)。分析谷丙轉(zhuǎn)氨酶（ALT）、乙型肝炎核心相關(guān)抗原（HBeAg）、乙肝病毒脫氧核糖核酸（HBV DNA）、年齡及性別與肝組織病理的相關(guān)性。 研究結(jié)果： 1.129例患者中，炎癥活動(dòng)度分級(jí)為G1、G2、G3和G4者依次為80、43、3和3例，，分別占62.0%、33.3%、2.3%和2.3%；纖維化分級(jí)為S0、S1、S2、S3和S4者依次為11、50、39、16和13例，分別占8.5%、38.8%、30.2%、12.4%和10.1%；其到G2/S2及以上共72例，占55.8%。 2.肝臟的炎癥活動(dòng)度和纖維化程度隨血清ALT的增高而加重，正常ALT組（ALT＜1×ULN）、ALT輕度升高組（1×ULN≤ALT＜2×ULN）、ALT明顯升高組（ALT≥2×ULN）三組之間比較，差異有統(tǒng)計(jì)學(xué)意義。 3.在ALT＜2×ULN組中，≥35歲年齡層患者肝組織學(xué)≥G2/S2者的比例高于＜35歲者，差異有統(tǒng)計(jì)學(xué)意義(χ~2=10.71，P＜0.05；χ~2=8.93，P＜0.05)。而ALT明顯升高組中，兩個(gè)年齡層≥G2/S2者的比例比較，差異無(wú)統(tǒng)計(jì)學(xué)意義。 4.血清HBV DNA、HBeAg狀態(tài)及性別與肝臟組織學(xué)改變程度沒有顯著性差別。 結(jié)論： HBeAg狀態(tài)及HBV DNA水平不能準(zhǔn)確反應(yīng)慢性HBV感染者的肝組織病變程度，患者ALT、年齡水平可以作為慢性HBV感染者肝組織病變程度的參考指標(biāo)，但不能依靠單一生化指標(biāo)反應(yīng)肝組織病變程度。對(duì)ALT＜2×ULN的35歲以上慢性HBV感染患者應(yīng)考慮進(jìn)行肝臟活檢，特別是年齡較大者。
[Abstract]:Objective:. The influencing factors of liver histology in patients with chronic hepatitis B virus (HBV) were analyzed by means of liver histology examination. Methods:. From March 2010 to August 2011, the data of 129 patients with chronic HBV infection who were hospitalized in the infection Department of the first affiliated Hospital of Anhui Medical University and examined by liver histopathology were collected. Hepatitis B virological markers, hepatitis B virus replication, etc. All cases were performed liver biopsy under the guidance of B-ultrasound, The relationship between alt, HBeAg, HBV DNA DNA, age, sex and liver pathology was analyzed in this paper. The liver tissue inflammation activity and fibrosis degree were divided into three groups: alanine aminotransferase (alt), hepatitis B core antigen (HBeAg), hepatitis B virus DNA (HBV DNA), age and sex. Results of the study:. 1.Among 129 patients, the inflammatory activity grade of G1G2OG3 and G4 were 8043K3 and 3, respectively, accounting for 63. 0% and 2. 3%, respectively, and the fibrosis grades of S0 S1, S2, S2, S3 and S4 were 11503916 and 13, accounting for 8. 5% and 10. 1%, respectively, and there were 72 cases with G2 / S 2 and above, accounting for 55.8B. 2. The degree of inflammatory activity and fibrosis of liver increased with the increase of serum ALT. There was a significant difference among the three groups: the alt < 1 脳 ULN 鈮

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