抗-HBs阳性肝炎72例临床与病理分析

目的分析单项抗-HBs阳性肝炎的临床与病理特征,提高对单项抗-HBs阳性肝炎的认识.方法 对72例单项抗-HBs阳性肝炎患者进行肝炎病毒血清学标志、肝功能、血清HBV DNA等检测及肝活组织病理和免疫组化检查.结果 72例患者除4例脂肪肝和3例Dubin-Johson综合征外,另65例中89.2%为慢性肝炎(58/65),其中慢性肝炎轻型占79.3%(46/58).临床与病理诊断总符合率为61.1%,临床表现和肝功能变化与肝组织炎症活动度密切相关.3.2%的患者示肝内HBsAg或/和HBcAg阳性,血清HBV DNA阳性为7.9%.结论单项抗-HBs阳性肝炎多为慢性肝炎,临床表现轻,炎症纤维化程度较轻,但有HBV复制的可能性.肝穿刺病理及免疫组化检测有助于明确诊断.

An Analysis on the Pathologic and Clinical Status in 72 Patients with Positive HBsAb

Objective To analyze the clinical and pathological features of hepatitis B with single HBsAb-positive. Methods 72 patients with HBsAb-positive were examined with serological hepatitis viral marker, liver function, HBV DNA level and liver biopsy.Results Most patients with HBsAb-positive were chronic hepatitis (89.2%), and mild chronic hepatitis accounted to 79 3% in these patients. The rate of consistence between clinical and pathological diagnosis were 61 1%. Changes of the clinical situation and liver function were correlated with the activity of inflammation in liver. HBsAg positive and/or HBeAg positive were detected in 3 2% patients, and 7 9% were detected with HBV DNA positive in these people. Conclusions Most patients with HBsAb positive are mild chronic hepatitis, but the virus still has the ability of replication. The method of liver biopsy and immunohistochemistry can help to diagnoses.