HBeAg阳性和阴性慢性乙型肝炎患者病理与细胞因子对比研究

目的探讨HBeAg阳性和HBeAg阴性慢性乙型肝炎(CHB)患者病理分级和分期频数分布情况及与肝纤维化有密切关系的细胞因子α平滑肌肌动蛋白(α-SMA)与转化生长因子β1(TGF-β1)的半定量评分之间的关系。方法随机选取进行肝组织活检的CHB患者118例,HBeAg阳性组57例,HBeAg阴性组61例。所有病例进行肝穿刺活组织检查,并进行炎症分级(G)和纤维化分期(S)诊断,免疫组化标记肝组织中α-SMA及TGF-β1表达,并进行半定量评分。对比2组α-SMA与TGF-β1表达情况。结果 HBeAg阴性组炎症分级G3～4级、纤维化分期S3～4期患者明显多于HBeAg阳性组;TGF-β1表达在1分组HBeAg阳性组频数分布明显高于HBeAg阴性组,而在3分组及4分组中HBeAg阴性组频数分布明显多于HBeAg阳性组;α-SMA在3分组及4分组中HBeAg阴性组频数分布明显高于HBeAg阳性组。结论 HBeAg阴性CHB患者更需要进行早期及时有效的抗病毒治疗,TGF-β1及α-SMA的阳性表达情况可评估对乙型肝炎患者肝纤维化程度。

The comparation study of pathology and cytokines about HBeAg positive and negative patients with chronic hepatitis B

Objective It is to approach the frequency distribution of different pathological grade and stage about HBeAg positive and HBeAg negative chronic hepatitis B(CHB) patients,and to analysis the relationship about semi-quantitative score of TGF-β1 and α-SMA of two groups in CHB patients.Methods 118 patients with CHB patients were randomly selected for liver biopsy.HBeAg positive patients were 57 cases,HBeAg negative patients were 61 cases.Liver biopsy was performed in 118 patients with CHB.and the inflammation grade(G) and fibrosis stage(S) diagnosis were carried out.The expression of α-SMA and TGF-β1 in liver tissue was observed by immune histochemical techniques,and semi-quantitative score of α-SMA and TGF-β1 was carried out.The expression of α-SMA and TGF-β1 with HBeAg positive group and HBeAg negative group were compared.Results The number of the HBeAg negative group was significantly higher than the HBeAg positive group in G3～4 and S3～4;the expression of TGF-β1 in HBeAg positive group was significantly higher than the HBeAg negative group in 1 score group,and on the contrary in 3 score and 4 score group.The expression of α-SMA in HBeAg negative group was significantly higher than he HBeAg positive group in 3 score and 4 score group.Conclusion HBeAg negative CHB patients need more early and effective antiviral treatment,the positive expression about TGF-β1 and α-SMA of CHB patients can be used as the assessment of liver fibrosis.