You Shao-li, Xing Han-qian, Liu Hong-ling, Rong Yi-hui, Zhu Bin, Xin Shao-jie
302 Hospital of PLA, Beijing 100039, China.
Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2007 Dec;21(4):374-6.
To investigate the characteristics of the hepatic pathological and clinical features of patients with hepatitis B virus (HBV) in immune tolerant stage and find the better measure of diagnosing patients chronic infected by HBV in immune tolerant phase.
135 patients with HBV chronic infection and persistently normal serum alanine aminotransferase (ALT) levels were involved in this study, whose serum HBeAg and HBV DNA were positive. Statistical analysis included the ages, sex, serum levels of HBVDNA, ALT and histological grade. The grades of inflammation and fibrosis were obtained through hepatic biopsy performed on all the patients.
Mean age in those patients was 22.61 +/- 8.95 years old. All those patients were divided into two groups according to histological grade: low- histological grade group, G < or = 1 and S < or = 1; and high-histological grade group, G > or = 2, S > or = to 2. Levels of histological grade were low in most of patients (99/135). Patients of low-histological grade had no difference in age, sex and family history of HBsAg carriers. Compared with low-normal ALT (ALT less than 30U/L), those with high-normal ALT (ALT > or = 30U/L) had a greater frequencies of high-histological grade. Compared with high HBVDNA (HBVDNA > or = 10(7) copies/ml), those with low HBVDNA (HBVDNA less than 10(7) copies/ml) had a greater frequencies of high-histological grade.
Levels of histological grade were low in most of patients with HBV chronic infection, serum HBeAg and HBVDNA positive, persistently normal serum ALT levels, but some of them were high-histological grade. It showed those patients were not all in immune tolerant stage of chronic HBV infection. Examination of ALT and HBVDNA are helpful to evaluate hepatic pathological damage for them.
探讨免疫耐受期乙型肝炎病毒（HBV）感染者肝脏病理及临床特征，寻找诊断免疫耐受期慢性HBV感染者的更佳方法。
本研究纳入135例慢性HBV感染者，其血清丙氨酸氨基转移酶（ALT）水平持续正常，血清HBeAg和HBV DNA阳性。统计分析内容包括年龄、性别、血清HBV DNA水平、ALT水平及组织学分级。所有患者均通过肝脏活检获取炎症和纤维化分级。
这些患者的平均年龄为22.61±8.95岁。所有患者根据组织学分级分为两组：低组织学分级组，G≤1且S≤1；高组织学分级组，G≥2，S≥2。大多数患者（99/135）的组织学分级较低。低组织学分级组患者在年龄、性别及HBsAg携带者家族史方面无差异。与低正常ALT（ALT＜30U/L）者相比，高正常ALT（ALT≥30U/L）者高组织学分级的频率更高。与高HBV DNA（HBV DNA≥10⁷拷贝/ml）者相比，低HBV DNA（HBV DNA＜10⁷拷贝/ml）者高组织学分级的频率更高。
大多数血清HBeAg和HBV DNA阳性、血清ALT水平持续正常的慢性HBV感染者组织学分级较低，但部分患者组织学分级较高。这表明这些患者并非均处于慢性HBV感染的免疫耐受期。检测ALT和HBV DNA有助于评估他们的肝脏病理损伤。
