乙型肝炎患者抗病毒前后肝组织病理检查的变化与意义

目的：通过对慢性乙型肝炎患者抗病毒治疗前后肝组织病理检查的差异性比较，初步探讨干扰素与核苷（酸）类似物抗病毒治疗效果。方法对29例单独应用干扰素或核苷（酸）类似物治疗的慢性乙型肝炎患者，于治疗前和治疗后48周进行肝组织活检，用半定量系统计分方案对治疗前后肝组织学进行评分，比较治疗前后变化并分析其意义。结果治疗前后相比，HBV DNA完全应答组获得显著的组织学改善。抗病毒治疗48周干扰素与核苷（酸）类似物两种抗病毒方式相比较无差异。结论无论是干扰素或是核苷（酸）类似物抗病毒，获得病毒学完全应答均可明显改善肝脏炎症、纤维化程度，不同机制的抗病毒药物治疗在48周时肝脏组织学变化无明显差异。

Changes and significance of liver histology before and after antiviral therapy in patients with chronic hepatitis B

Objective To investigate the change of liver histology and evaluate the efifcacy of two kinds of different mechanisms antiviral therapy on patients with chronic hepatitis B （CHB）.Methods Liver biopsy tissues were done in 29 CHB patients who adopt interferon therapy or nucleos（t）ide analogues therapy before therapy and 48 weeks later. Histological scores were evaluated according to the semi-quantitative rating system.Results Compared with the liver inlfammation and ifbrosis, HBV DNA completely response group get the histologic improvement significantly. The effect of interferon and nucleos（t）ide analogues therapy are indiscriminate at 48 weeks.Conclusions Whether interferon therapy or nucleos（t）ide analogues therapy which could get virological completely response, get the obvious degree of improvement, and at 48 weeks the two kinds of different mechanisms antiviral therapy efifcacy are indiscriminate.