不同年龄段慢性乙型肝炎病毒携带者肝活体组织的病理分析

目的 分析各年龄段慢性HBV携带者肝活组织检查病理炎症分级≥G2级或纤维化分期≥S2者所占比例,探讨肝活组织检查最佳时机,指导抗病毒治疗. 方法 收集292例慢性HBV携带者肝活组织检查病理结果,按年龄分为3组,计算各年龄段炎症分级≥G2或纤维化分期≥S2者各占比例,比较组间差异.计数资料统计学描述用构成比,统计分析采用x2检验.P＜ 0.01为差异具有统计学意义. 结果 3个年龄段慢性HBV携带者炎症分级≥G2级或纤维化分期≥S2者,在11 ～ 29岁组占26.5％ (36/136),30～39岁组占39.4％ (37/94),40～60岁组占58.1％ (36/62),总体差异有统计学意义(P＜ 0.01).30 ～ 39岁组炎症分级≥G2级或纤维化分期≥S2者的比例为39.4％ (37/94),与40～60岁组58.1％ (36/62)比较,差异无统计学意义(P＞0.01).且30岁以前的慢性HBV携带者炎症分级≥G2级或纤维化分期≥S2者占26.5％(36/136),30岁以后的慢性HBV携带者炎症分级≥G2级或纤维化分期≥S2者占46.8％(73/156),差异有统计学意义(P＜0.01). 结论 年龄≥30岁为慢性HBV携带者肝活组织检查最佳时机,因此,对≥30岁慢性HBV携带者应尽早做肝穿刺活组织检查,对预防疾病发展,指导抗病毒治疗有重要意义.

Pathological grading analysis of liver biopsies in chronic hepatitis B virus carriers of different age ranges

Objective To study the best time of taking liver biopsy for chronic HBV carriers of age ranges and then guiding antiretroviral treatment.Method The liver biopsy pathologic results of 292 cases of chronic HBV carriers were collected from the First Affiliated Hospital of Kunming Medical College.The patients were divided into three groups according to ages.The differences between groups were compared by calculating the ratio of inflammation above G2 or fibrosis staging above S2.Result The percentages of the chronic HBV carriers with liver histopathology irflamination graded above G2 or fibrosis staging above S2 were 26.5％ (36/136) in 11-29 year-old group,39.4％ (37/94) in 30-39 year-old group and 58.1％ (36/62) in 40-60 year-old group.Significant difference existed among groups in general ( P ＜ 0.01).39.4％ (37/94) of chronic HBV carriers were found with inflammation graded above G2 or fibrosis staging above S2 in 30-39 year-old group,no statistically significant defference found between group 30-39 years old and group and 40- 60 years old 58.1％ (36/62) (P＜ 0.01).26.5％ (36/136) of chronic HBV carriers under 30 years old were with inflammation graded above G2 or fibrosis staging above S2 as compared with the percentage of 46.8％ (73/156) in the chronic HBV carriers over 30 years old group,and significant defference existed between the two groups ( P ＜ 0.01).Conclusion The best time choice of taking liver biopsy should be at the ages elder than or equal to 30.