阴虚体质与慢性无症状HBV携带者肝组织病理改变的联系

目的:探讨慢性无症状HBV携带者阴虚体质与肝组织病理改变的联系,慢性无症状HBV携带者不同肝组织病理程度与HLA-DRB1、DQA1基因多态性的联系,通过调节病理体质,延缓或抑制病情进展。方法:临床选择慢性无症状HBV携带者105例,进行中医体质分型:47例阴虚质和58例非阴虚质,105例患者行肝组织活检术,进行肝组织病理学检查,留取血标本,检测HBsAg、HBV-DNA、HBeAg及肝功能,采用聚合酶链反应-序列特异性引物(PCR-SSP)技术测定HLA-DRB1、HLA-DQA1等位基因型。结果:在慢性无症状HBV携带者阴虚质组与非阴虚质组间,HBsAg、HBV-DNA、HBeAg及肝功能指标的差异均无统计学意义(P值均﹥0.05)。105例慢性无症状HBV携带者,经病理诊断肝组织无炎症和(或)纤维化改变者仅11例(10.5%),轻度慢性肝炎80例(76.2%),中度慢性肝炎8例(7.6%),重度慢性肝炎6例(5.7%)。阴虚质组的肝组织纤维化病变的发生率为34.0%,显著高于非阴虚质组的15.5%,差异有统计学意义(P=0.027﹤0.05);肝组织炎症活动度在两组间的差异无统计学意义(P﹥0.05)。HLA-DRB1、HLA-DQA1在不同肝组织病理程度间的基因频率,差异无统计学意义(P﹥0.05)。结论:多数慢性无症状HBV携带者肝组织病理为轻度慢性肝炎,少数为中度和重度;阴虚体质患者肝组织纤维化病变的发生率高于非阴虚体质,提示阴虚体质的慢性无症状HBV携带者感染HBV后易发生不同程度的纤维化改变,可能易发展为肝硬化。

Study on the Connection of Yin Deficiency and Hepatic Pathology in Chronic Asymptomatic HBV Carrier

Objective:To observe the relationship of Yin deficiency and hepatic pathology and genotyping of HLA-DRB1 HLA DQA1 alleles in chronic asymptomatic HBV carrier,and discuss the effect of constitution factor on degrees of inflammatory activity and fibrosis.To improve inflammatory activity and fibrosis by adjusting pathological.Method:According to the diagnostic criteria,105 cases of chronic HBV carriers were selected,then divided into two groups:Yin deficiency(47 cases)and non-Yin deficiency(58 cases).The general condition such as age,gender and family history were recorded.The bioptic liver specimens from 105 cases of patients with chronic asymptomatic HBV carrier were analyzed.The examine of pathogeny,hepatic function and genotyping of HLA-DRB1 HLA DQA1 alleles were tested.Results:Through statistical analysis,there was no significant difference of pathogen indicators(HBsAg,HBV-DNA,HBeAg)and liver functional indices(TBiL,DBiL,ALT,AST,AlB,GLB)between the two groups(P>0.05).The difference was not statistically significant on inflammatory activity between the two groups(P>0.05).The incidence of fibrosis in patients of Yin deficiency was significantly higher than that in non-Yin deficiency group(P<0.05).There was no statistical significance on HLA-DRB1,HLA-DQA1 allele frequency among the degrees of liver pathologic histology in chronic asymptomatic HBV carrier(P>0.05).Conclusion:Most chronic asymptomatic HBV carriers had mild liver pathologic histology,but some were moderate and severe hepatitis.The incidence of fibrosis in patients of Yin deficiency was significantly higher than that in non-Yin deficiency group.Yin deficiency has susceptibility to liver fiberosis,further progress to be liver cirrhosis namely.