194例慢性乙型肝炎病理及其与血清HBV DNA、HBeAg、ALT关系的研究

目的探讨慢性乙型肝炎病理及其与血清HBV DNA、HBeAg、ALT关系。方法对194例慢乙肝患者进行肝组织病理、HBV免疫组化检查,并检测肝功能、血清HBVM和HBV DNA。结果血清HBeAg阳性组的肝组织G2、G3~4、S2、S3~4发生率与阴性组比较差异有统计学意义,肝组织S0组与S1~4组比较差异有统计学意义,肝组织G0~1组与G2~4组、HBcAg阳性组与阴性组的HBV DNA含量比较差异亦有统计学意义,肝组织HBsAg表达为" "者与" ~ "者血清HBV DNA含量比较差异无统计学意义,肝组织达S1或(和)G2以上者血清ALT水平分别为:<40U/L组占28.57%,40~80U/L组占53.33%,81~400U/L占80.15%,>400U/L组占77.88%。结论血清HBV DNA与肝组织HBcAg表达有一致性,与肝内HBsAg无关,HBV DNA含量低可能是肝组织炎症活动度和纤维化程度高,ASC和轻度肝损害者应争取肝活检,以及时判断肝组织病理程度和治疗时机。

Relationship among pathological changes in liver tissues and level of serum HBV DNA,HBeAg and ALT of l94 patients with chronic hepatitis B

Objective To study the relationships among pathological and immunohistochemical changes in liver tissues,and the HBeAg,HBV DNA,ALT level in the patients with chronic hepatitis B.Methods Pathological and immunohistochemical, examinations,of liver tissue liver function tests,serum HBV and HBV DNA detection were performed in 194 patients with chronic hepatitis B.Results There was significant difference between the serum HBeAg positive group and the negative group in G2,G3-4,S2,S3-4 in liver tissues; The serum HBV DNA level of the groups S0 and S1-4,and the hepatic activity index between the groups G0-1 and G2-4 were significantly different. And the hepatic HBcAg positive group and HBcAg negative group were significantly different too. There was no significant difference between the HBsAg level in liver tissues as " " group and the " " group.The pathological diagnosis as S1 or (and)G2 is respectively 28.57%,53.33%,80.15%,77.88%among the four groups with normal,mild,moderate,severe elevated serum ALT level.Conclusion Serum HBV DNA correlated with HBcAg expression in liver tissue,the HBsAg level in liver tissues have no relationship with the serum HBV DNA level,The patients with low serum HBV DNA level may have high index of hepatic activity and hepatic fibrosis. Asymptomatic carriers and patients with low serum ALT level should be encouraged to accept liver biopsy. It can determine the degree of liver inflammation and fibrosis and timing of treatment.