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低ALT水平的慢性HBV感染者血清HBsAg水平与肝组织学的相关性
Relationship between serum HBsAg level and liver histological features in chronic HBV infection patients with low ALT levels
文章发布日期:2015年09月06日  来源:  作者:陈学福,陈小苹,马晓军,等  点击次数:2060次  下载次数:395次

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【摘要】:目的通过分析低ALT水平慢性HBV感染者血清HBsAg水平与肝组织炎症分级及纤维化分期的关系,探讨影响肝组织学的相关因素。方法收集2010年1月-2013年12月在广东省人民医院就诊的慢性HBV感染者511例,检测肝组织学、血清HBsAg定量、HBV DNA定量。正态分布的计量资料两组间比较采用t检验,非正态分布的资料多组间比较采用Kruskal-Wallis H检验,进一步两两比较采用Nemeny检验。计数资料组间比较采用χ2检验,采用Spearman等级相关分析法判断HBsAg水平与肝组织炎症分级和纤维化分期的相关性。结果511例患者有不同程度肝组织异常。年龄≥40岁组HBeAg阳性率、HBsAg定量、HBV DNA定量均低于年龄<40岁组,差异均有统计学意义(统计值分别为86.80、2.99、7.25,P值分别为<0000 1、0.003、0.000 1)。不同年龄组肝组织炎症分级和纤维化分期的分布差异有统计学意义(χ2值分别为70.03、61.92,P值均<0.000 1)。Spearman等级相关分析结果显示,HBeAg阳性和HBeAg阴性患者,HBsAg水平与肝脏炎症分级及纤维化分期均呈负相关关系(r值分别为-0.245、-1.51、-0.153、-0.181,P值分别为<0000 1、0.019、0.012、0.005)。结论低ALT水平慢性HBV感染者年龄是影响肝脏组织学进展的重要因素之一,且HBsAg水平与肝组织炎症分级和纤维化分期均呈负相关关系,提示HBsAg水平可作为此类患者无创性判断肝脏组织学状态的一项重要指标。
【Abstract】:ObjectiveTo investigate the factors influencing the liver histological features in chronic hepatitis B virus (HBV) infection patients with low alanine transaminase (ALT) levels by analyzing the relationship of serum hepatitis B surface antigen (HBsAg) level with liver inflammation grade and fibrosis stage. MethodsA total of 511 HBV infection patients admitted to our hospital from December 2010 to December 2013 were studied. The liver histological features, serum HBsAg level, and HBV DNA copy number were examined. Comparison of categorical data between different groups was made by chi-square test, comparison of continuous data following the normal distribution was made by t test, and comparison of continuous data not following the normal distribution was made by Kruskal-Wallis H test. The relationship of serum HBsAg level with liver inflammation grade and fibrosis stage was determined by Spearman′s rank correlation analysis. ResultsAll patients showed different degrees of hepatic histological abnormalities. The group aged more than or equal to 40 years had significantly lower HBeAg positive rate, HBsAg level, and HBV DNA copy number compared with the group aged less than 40 years (χ2=86.8, P<0.000 1; t=2.99, P=0.003; t=7.25, P<0.000 1). The groups with different ages had significant differences in liver inflammation grade and fibrosis stage (χ2=70.03, P<0.000 1; χ2=61.92, P<0.000 1). The Spearman′s rank correlation analysis indicated that in both HBeAg-positive and -negative patients HBsAg level was negatively correlated with liver inflammation grade (r=-0.245, P<0.000 1; r=-1.51, P=0.019) and fibrosis stage (r=-0.153, P=0.012; r=-0.181, P=0.005). ConclusionAge is one of the important factors influencing the liver histological progression in chronic HBV infection patients with low ALT levels. HBsAg level is negatively correlated with liver inflammation grade and fibrosis stage in chronic HBV infection patients with low ALT levels, so it could be used as an important non-invasive indicator for the liver histological status in these patients.
【关键字】:肝炎, 乙型, 慢性;肝炎表面抗原, 乙型;丙氨酸转氨酶;组织学
【Key words】:hepatitis B, chronic; hepatitis B surface antigens; alanine transaminase; histology
【引证本文】:陈学福, 陈小苹, 马晓军, 等. 低ALT水平的慢性HBV感染者血清HBsAg水平与肝组织学的相关性[J]. 临床肝胆病杂志, 2015, 31(10): 1688-1691.

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