血清白蛋白、球蛋白与慢性乙型病毒性肝炎病理的相关性研究

目的：研究血清白蛋白（Albumin，ALB）、球蛋白（Globulin，GLO）水平及白蛋白／球蛋白（A／G）比值与慢性乙型病毒性肝炎肝组织炎症活动度及纤维化程度的关系。方法：对102例慢性乙型病毒性肝炎患者进行肝功能检测，测定血清ALB、GLO水平。所有病例均行肝穿刺活检，并进行肝组织炎症活动度（G）及纤维化程度（S）的分期。结果：（1）血清ALB和A／G比值与肝组织炎症活动度呈负相关（r=-0．405，r=-0．400，均P〈0．001），与肝组织纤维化程度呈负相关（r=-0．356，r=-0．271，均P〈0．01）；（2）血清GLO水平与肝组织炎症活动度呈正相关（r=-0．221，P〈0．05），血清GLO水平与肝组织纤维化程度无相关性（P〉0．05）；（3）G、S在〈2与≥2之间血清ALB水平和A／O比值的差异有统计学意义（P〈0．01）。结论：血清ALB、GLO水平和A／G比值可作为评估慢性乙型病毒性肝炎肝组织炎症活动度和纤维化程度的参考指标，在评估慢性乙型病毒性肝炎纤维化时血清ALB水平较GLO水平更为敏感。

A STUDY ON THE CORRELATION OF SERUM ALBUMIN AND GLOBULIN WITH HEPATIC PATHOLOGY IN CHRONIC HEPATITIS B

Objective： To study the correlation of serum albumin（ALB） and globulin（GLO） and albumin/ glohulin（A/G） ratio with hepatic inflammatory activity and fibrosis stage in patients with chronic hepatitis B. Methods：Serum albumin and globulin were measured in 102 patients with chronic hepatitis B. Meanwhile the liver biopsies were performed in all patients, and the hepatic inflammatory activity grade and fibrosis stage were evaluated. The correlation of serum albumin with liver histopathology were analyzed. Results： ① Serum albumin and A/G ratio were negatively correlated with inflammatory activity grade of liver （ r =-0. 405, P 〈0. 001）and （r =-0.400, P〈0. 001）;repectively, and negatively correlated with fibrosis stage （r = -0.356, P %0.01）and （r=- 0. 271, P 〈0. 01 ） ; respectively. ② Serum was positively correlated with inflammatory activity grade （ r =0. 221, P 〈0. 05）. There was no significant correlation between serum globulin and fibrosis stage. ③Between low（〈2） and high（≥2） inflammatory activity and fibrosis stage, there was significant difference in serum albumin and A/G ratio. Conclusion： Serum albumin, globulin and A/G ratio can be used as the reference indexes for estimating hepatic inflammatory activity grade and fibrosis stage, serum albumin is more sensitive than globulin in estimating fibrosis stage in patients with chronic hepatitis B.