Wei Ni, Yang Dong, Yang Fang, Wang Ying, Zhao Bing, Lü Da-gang
Sixth People's Hospital of Shenyang, Shenyang 110006, China.
Zhonghua Gan Zang Bing Za Zhi. 2007 May;15(5):330-3.
To investigate the relationship between hepatic histopathological changes and clinical characteristics in chronic HBV carriers.
A retrospective analysis was performed based on the hepatic biopsy findings, clinical laboratory results, and ultrasound examinations in 142 chronic HBV carriers. The patients were divided into two groups according to their serum HBV DNA replication and the pathological alterations in their livers.
The average age of the 142 patients was (24.8+/-8.7) years old. Among them, 129 were diagnosed as chronic HBV carriers based on their positive HBV DNA results. Thirteen were diagnosed as non-active HBsAg carriers. Hepatitis B family history was found in 31.0% of the cases. Normal liver tissues (G0S0) were found in the specimens of 33 cases (G > or = 1 and/or S > or = 1) chronic hepatitis B was diagnosed based on the biopsies in 106 cases, including an early stage of hepatic cirrhosis in 1 case (G4S4). There were no obvious differences between HBV DNA positive and negative group cases. The levels of HBV DNA in all the 129 cases of chronic HBV carriers were more than 1.0 x 10(4) copy/ml and the average value was (7.58+/-0.99) log10 copy/ml. Of the 129 cases, 123 were HBeAg positive (95.3%). Increased levels of gamma-globulin were detected in 45.8% of the cases and fibrosis index increased in 37.1%; 40.1% of the cases showed abnormalities in their ultrasound examinations. The average PCIII value of the chronic HBV carrier group (G > or = 1 and/or S > or = 1) was higher than that of the non-active HBsAg carrier group (P = 0.016). Spearman's analysis indicated that the inflammation grade (G) was correlated with the hepatic fibrosis index PCIII, and the correlation coefficient was 0.391 (P = 0.003).
The patients in our study have a higher HBV DNA replication in their sera and have mild inflammation in their livers. Inflammation grade (G) and fibrosis stage (S) have no correlation with the level of HBV DNA or the state of HBeAg positivity. The increased level of PCIII might be related to their hepatic inflammation.
探讨慢性HBV携带者肝脏组织病理学变化与临床特征之间的关系。
基于142例慢性HBV携带者的肝穿刺活检结果、临床实验室检查结果及超声检查进行回顾性分析。根据患者血清HBV DNA复制情况及肝脏病理改变将患者分为两组。
142例患者的平均年龄为（24.8±8.7）岁。其中，129例根据HBV DNA结果阳性被诊断为慢性HBV携带者。13例被诊断为非活动性HBsAg携带者。31.0%的病例有乙肝家族史。33例标本肝脏组织正常（G0S0）；106例根据活检诊断为慢性乙型肝炎（G≥1和/或S≥1），其中1例为早期肝硬化（G4S4）。HBV DNA阳性组与阴性组病例之间无明显差异。129例慢性HBV携带者的HBV DNA水平均超过1.0×10⁴拷贝/ml，平均值为（7.58±0.99）log₁₀拷贝/ml。129例中，123例HBeAg阳性（95.3%）。45.8%的病例检测到γ-球蛋白水平升高，37.1%的病例纤维化指数升高；40.1%的病例超声检查异常。慢性HBV携带者组（G≥1和/或S≥1）的平均PCIII值高于非活动性HBsAg携带者组（P = 0.016）。Spearman分析表明，炎症分级（G）与肝纤维化指数PCIII相关，相关系数为0.391（P = 0.003）。
本研究中的患者血清HBV DNA复制水平较高，肝脏炎症较轻。炎症分级（G）和纤维化分期（S）与HBV DNA水平或HBeAg阳性状态无关。PCIII水平升高可能与其肝脏炎症有关。
