40例慢性乙型肝炎轻度患者肝组织病理学变化研究

目的探讨40例成人谷丙酶正常或轻度升高的慢性HBV感染者肝组织病理学的变化。方法常规进行肝穿刺组织学检查，对肝组织进行炎症分级及纤维化分期；采用化学发光法对该组患者进行血清HA、LN、PCⅢ、cⅣ水平的检测；应用全自动生化仪检测主要血生化指标。分析上述血清学指标水平与肝组织炎症分级及纤维化分期之间的关系。结果在40例慢性HBV感染者中，G1S0 3例，G1S1 9例，G1S2 1例，G1S3 3例，G1S4 4例，G2S1 10例，G2S2 3例，G2S4 4例，G3S4 2例，G4S4 1例；肝组织炎症分级和纤维化分期〈G2S：组血清ALT、ALB及CHE水平较≥G2S2 组有所增加，血清AST、TBIL水平较≥G2S2组有所减少，其中仅血清AST水平在两组间有显著性差异（P〈0．05），血清ALT、TBIL、ALB、CHE水平在组间均无统计学差异（P〉0．05）。肝组织纤维化分期≥S2组血清HA、LN、PCⅢ、CIV水平较〈S2组均有所增加，其中血清HA、PCⅢ、CIV水平在组间有统计学差异（P〈0．05），而血清LN水平在组间无显著性差异（P〉0．05）。结论对成人ALT正常或轻度升高的HBV感染者应及时行肝穿刺活检，以便作出正确的诊断和及时处理，防止病情向肝硬化、肝癌的进展。

The pathologic changes of liver tissues in 40 adult hepatitis B viral infection patients with normal or mildly elevated serum ALT levels

Objective To explore the pathologic changes in 40 adult patients with chronic HBV infection who were with normal or mildly elevated serum ALT levels.Method To analyze the relation of hepatic pathologic grades indexes and fiberized stages indexes,detected by liver biopsy,serum markers of liver fibrosis(HA,LN,PCⅢ,CⅣ),detected by chemiluminescence method,main Liver function,detected by automatic biochemistry analyzer,of 40 patients with chronic hepatitis B infection.Results In 40 patients with chronic hepatitis B infection,the liver pathologic manifestations were G1S0 in three,G1S1 in nine,G1S2 in one,G1S3 in three,G1S4 in four,G2S1 in ten,G2S2 in three,G2S4 in four,G3S4 in two,and G4S4 in one;The serum ALT,ALB and CHE levels in patients with liver inflammation grade and fibrosis stage0.05).Conclusion The liver biopsies in HBV infected patients with normal or mild abnormal ALT should be performed in time to guide antiviral treatment and prevent the progression of the disease to liver cirrhosis and liver cancer.