Lu Chuan-Tong, Gao Guo-Sheng
The Infectious Disease Hospital of Ningbo City, Ningbo 315010, Zhejiang, China.
Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2011 Jun;25(3):214-6.
To explore the histopathological features of chronic hepatitis B virus (HBV) carriers and chronic hepatitis B (CHB) patients with mildly elevated serum alanine aminotransferase (ALT).
105 patients were divided into three groups according to serum ALT levels: Group A [ALT level < or = 0.5 x upper limits of normal (ULN)], Group B (0.5 x ULN < ALT level < or = 1 x ULN) and Group C(1 x ULN < ALT level < 2 x ULN). Grade of liver inflammation and stage of liver fibrosis in the three groups were compared. The changes in clinical parameters were then observed in patients who had liver histopathological changes.
Among 40.95% of the patients, hepatitis degree went to G2 or even worse; and among 30.43% of the patients whose ALT level were normal, the hepatitis degree reached G2 or even worse. In 26.67% of the patients, degree of fibrosis went to S2 or even worse, and for the 17.39% patients whose ALT level were normal, degree of fibrosis went to S2 or even worse. The aggravation of liver inflammation and fibrosis was correlated with ALT and hyaluronic acid increasing (all P < 0.05).
Frequent monitoring of serum ALT and hyaluronic acid may help to understand histopathological changes in the liver. Liver biopsy applied to CHB should be regarded as a main basis if antiviral therapy should be conducted.
探讨慢性乙型肝炎病毒（HBV）携带者及血清丙氨酸氨基转移酶（ALT）轻度升高的慢性乙型肝炎（CHB）患者的组织病理学特征。
根据血清ALT水平将105例患者分为三组：A组[ALT水平≤0.5×正常上限（ULN）]、B组（0.5×ULN＜ALT水平≤1×ULN）和C组（1×ULN＜ALT水平＜2×ULN）。比较三组患者的肝脏炎症分级和肝纤维化分期。然后观察有肝脏组织病理学改变的患者临床参数的变化。
40.95%的患者肝炎程度达到G2级或更严重；30.43%的ALT水平正常的患者肝炎程度达到G2级或更严重。26.67%的患者纤维化程度达到S2级或更严重，17.39%的ALT水平正常的患者纤维化程度达到S2级或更严重。肝脏炎症和纤维化的加重与ALT及透明质酸升高相关（均P＜0.05）。
定期监测血清ALT和透明质酸可能有助于了解肝脏的组织病理学变化。如果要进行抗病毒治疗，肝活检应作为CHB患者的主要依据。
