慢性乙型肝炎病毒携带者和ALT轻度升高慢性乙型肝炎患者的肝脏病理及临床特征

目的 分析不同ALT水平慢性HBV携带者和血清ALT轻度升高慢性乙型肝炎患者肝组织病理学及临床改变,B超检查结果 的差异,寻找与肝组织学改变相关的因素. 方法 将128例患者分为3组:A组:ALT≤0.5×正常值上限(ULN),B组:0.5×ULN

Comparison of liver pathohistological and clinical characteristics between chronic HBV carriers and chronic hepatitis B patients with mild elevation in ALT

Objective To compare the fiver pathohistological and clinical features between chronic HBV carriers and chronic hepatitis B patients with mild elevated in ALT. Methods 128 patients were divided into 3 groups according to the ALT: group A: ALT≤0.5×ULN, group B: 0.5×ULN < ALT≤1× ULN, group C: 1×ULN < ALT < 2×ULN. The age, sex, serum HBV DNA, HBeAg status, expession of HBcAg in fiver, thickness of spleen, breadth of portal vein ,blood stream speed of protal vein, right liver obliqua diameter, grade of liver inflammation and stage of liver fibrosis were compared in the three groups. Results Among 128 patients, 57(44.5%) patients had G1 hepatitis and 71 (55.5%) had G2 hepatitis, no G0 hepatitis was found in these patients; 72 patients (56.3%) had S1 fibrosis, 30 (23.4%) patients had $2 fibrosis, and 26 (20.3%) patients did not have liver fibrosis. The fiver inflammation in group C was more aggravated than that in group A (P<0.05). And there were significant differences in thickness of spleen and fight liver obliqua diameter between group C and group A, as well as between group C and B (P all<0.01). With the aggravating of liver inflammation, the serum ALT, thickness of spleen, breadth of portal vein and expression of HBcAg in liver were increased obviously (P<0.05). With the aggravating of liver fibrosis, the thickness of spleen, breadth of portal vein, fight liver obliqua diameter and HBeAg negative patients were increased obviously, while the blood stream speed of portal vein was decreased obviously (P<0.01). Conclusion Among the chronic HBV infection patients whose ALT<2×ULN, there were 55.5% patients had G2 of liver inflammation and 23.4% patients had S2 of liver fibrosis. The serum ALT, thickness of spleen, breadth and blood stream speed of portal vein, fight liver obliqua diameter and expression of HBcAg in liver are associated with pathohistological changes in these patients.