肝活检对HBV携带者的诊断意义

目的探讨肝活检对HBV携带者的诊断意义。方法回顾性分析134例HBV携带者,在B超引导下行1秒钟快速肝穿刺活检术,行肝组织病理学检查。结果在134例患者中,仅2例（1.49%）肝组织病理学检查完全正常（G0S0）;在105例HBV DNA≥10^5copies/ml（或HBeAg阴性者HBV DNA≥10^4copies/ml）的HBV携带者中,肝组织炎症活动度≥G2者80例（76.19%）,即可实施抗病毒治疗;在100例HBeAg（＋）与34例HBeAg（-）感染者,肝组织炎症活动度和纤维化程度比较无明显统计学差异（P=0.308）;在不同肝组织炎症活动度和纤维化程度感染者,HBV DNA载量无明显的统计学差异（P=0.557）,HBV DNA≥10^7copies/ml与HBV DNA〈10^7copies/ml感染者比,肝组织炎症活动度和纤维化程度存在统计学差异（P=0.007,P=0.001）。结论对于慢性HBV携带者,应及时进行肝组织活检。

The histopathological manifestations in individuals with hepatitis B viral carriers

Objective The aim of this study was to investigate the clinic significance of liver biopsy in asymptomatic chronic hepatitis B virus carriers.Methods 134 individuals with chronic hepatitis B viral carriers received the liver biopsy.Results Liver biopsies showed hepatic necrosis inflammation and fibrosis in 1.49%(2/134)without any change;Among 105 patients who met the HBV DNA≥105copies/ml(or in HBeAg negative patients was≥104copies/ml),there were 80 cases whose liver inflammation≥G2;Between 100 patients with HBeAg(+)and 34 patients with HBeAg(-),there was no significantly statistical difference in their liver inflammation and fibrosis(P=0.308);the hepatic necrosis inflammation and fibrosis between group with HBV DNA<107copies/ml and those with HBV DNA≥107copies/ml were statistically different(P=0.007,P=0.001).Conclusions The liver biopsy should be done in chronic hepatitis B carriers in time.