慢性HBV感染者血清HBsAg定量水平 HBVDNA与肝脏组织病理学分析

目的 对丙氨酸转氨酶（ALT）≤2 ULN的慢性HBV感染者进行肝组织病理学检查,探讨血清HBsAg定量、HBVDNA、ALT与肝组织病理学的关系.方法收集154例ALT≤2 ULN慢性HBV感染者的肝穿刺病理结果,根据不同肝脏病理炎症活动度（G）分为两组,G1 组（0≤G〈2）和G2 组（2≤G≤4）,根据不同纤维化分期（S）亦分成2组,S1组（0≤S〈2）和S2组（2≤S≤4）,根据不同ALT水平分为2组,A1组（ALT≤40 U/L）和 A2组（40 U/L0.05）;S1组和S2组患者血清lgHBsAg定量分别是3.58（0.68,5.33）IU/ml和2.57（1.45,4.87）IU/ml,两组差异有统计学意义（P〈0.05）,S1和S2组患者lgHBVDNA定量分别是6.08（3.0,9.32）copies/ml和4.87（3.0,8.65）copies/ml,两组差异有统计学意义（P〈0.05）;A1组和A2组患者肝组织炎症程度及纤维化分期组间差异无统计学意义（P〉0.05）.结论 不同肝脏炎症程度和纤维化程度的慢性HBV 感染者间的lgHBsAg定量可能存在差异,肝脏炎症程度和纤维化程度较高者lgHBsAg定量水平可能较低,同样肝脏纤维化程度较高者lgHBVDNA水平可能较低.

Analysis of quantitative of HBsAg HBVDNA and liver tissue pathology in ALT normal or slightly elevated of chronic HBV infection

Objective To investigate the relationship between quantitative of HBsAg, HBVDNA, ALT in patients with ALT ≤ 2ULN of chronic HBV infection by liver biopsy. Methods Liver biopsy was performed in 154 patients with ALT ≤ 2 ULN of chronic HBV infection; the patients were divided into two groups, group G1 （0 ≤ G 〈 2） and group G2 （2 ≤ G≤4） according to the different stages of liver inflammation （G） , those patients were also divided into 2 groups, group S1 （0 ≤ S 〈 2 ） and group $2 （2 ≤ S ≤4 ） according to the different stages of fibrosis （S）, and they were also divided into 2 groups, group A1 （ ALTo〈40 U/L）, and group A2（ 40U/L 〈 ALTo〈80 U/L） according to the different levels of ALT, serum levels of HBVDNA, quantitative of HBsAg. ALT level was compared between the two groups respectively. Results Between group G1 andgroup G2 , serum quantitative of lgHBsAg was respectively3.32 （0.68, 5.33） IU/ml and 2.52 （1.45, 3.94）IU/ml,and the two groups had significant difference （P 〈 0.05） ; the levels of lgHBVDNA between two groups were respectively （ 5.46 ±2.03 ） copies/ml and 5.09 ± 1.97copies/ml, and the two groups had no statistical difference （ P 〉 0.05 ）. Between group SI and group S2 , serum quantitative of lgHBsAg was 3.58 （0.68, 5.33 ） IU/ml and 2.57 （ 1.45,4.87 ） IU/ml, and the two groups had sig- nificant difference （P 〈 0.05） ; the levels of lgHBVDNA between the two groups were 6.08 （3.0,9.32） copies/ml and 4.87 （ 3.0,8.65 ） copies/ml, and the difference between the two groups was statistically different （ P 〈 0.05 ）. The degree of liver inflammation and fibrosis between group A1 and group A2 had no significant difference （ P 〉 0.05 ）. Conclusion The quantitative of lgHBsAg is significantly different during different stages of liver inflammation and fibrosis , the quantitative of lgHBsAg in higher stages of liver inflammation, and the fibrosis may be lower than that in lower stages; similarly HBVDNA levels may be lower in higher stages of liver fibrosis.