肝脂肪变性促进慢性丙型肝炎病程进展的研究

目的 研究脂肪变性在慢性丙型肝炎疾病进程中的作用.方法 收集治疗前行肝穿刺病理检查的慢性丙型肝炎患者159例,按照感染HCV基因亚型分为基因1b型组、基因2a型组和其他基因型组,荧光定量PCR法检测所有病例血清HCV载量,组织学评估各组穿刺肝组织炎症坏死、纤维化和肝细胞脂肪变性程度.结果 HCV基因1b型和2a型感染患者占总病例的65.41%,63.52%(101/159)的慢性丙型肝炎患者发生肝细胞脂肪变性,不同基因型组间脂肪变性程度无统计学差异.不同基因型组HCV慢性感染者间炎症活动度、纤维化程度和脂肪变性程度无统计学差异(P均>0.05).肝脂肪变性与肝纤维化和炎症活动度均密切相关(r值分别为0.34和0.29,P均<0.01),但HCV感染病毒量与脂肪变性、肝纤维化和炎症活动度间无明显相关性.结论 脂肪变性促进慢性丙型肝炎病程进展.

Hepatic steatosis associated with the progression of chronic hepatitis C

Objective To study the role of hepatic steatosis in the progression of HCV.Methods 159 patients with chronic hepatitis C,performed biopsy,were divided into three groups according to subgenotype：genotype 1b group,genotype 2a group and the other group.Virus load of hepatitis C virus（HCV）in serum was measured by fluorescence quantitative polymerase chain reactivation.The histological changes of necroinflammation,fibrosis and hepatic steatosis in liver tissues were also assessed.Results 65.41 percent of patients with HCV were infected by HCV genotype 1b or genotype 2a.63.52 percent of patients presented hepatic steatosis.Statistically,there were no significant differences in necroinflammation,fibrosis and hepatic steatosis between the various HCV genotype groups（all P values0.05）.It was the steatosis that associated with fibrosis and necroinflammation（r value was 0.34 and 0.29 respectively,both P values0.01）.Conclusions Hepatic steatosis is associated with the progression of chronic hepatitis C.