HBeAg阳性和HBeAg阴性的慢性乙肝患者ALT轻度升高的肝组织病理

肝胆速递

http://www.ncbi.nlm.nih.gov/pubmed/22971279##
Zhonghua Gan Zang Bing Za Zhi. 2012 May;20(5):348-52. doi: 10.3760/cma.j.issn.1007-3418.2012.05.009.
[Characteristic of liver pathology in HBeAg-positive and HBeAg-negative chronic hepatitis B patients with mildly elevated ALT].
[Article in Chinese]
Liu SQ, Zhu XJ, Sun XH, Li M, Gao YQ.
Source

Department of Hepatology, Shanghai University of Tranditional Chinese Medicine, Shanghai, China.
Abstract

To analyse the live pathology characteristics in mild ALT-elevated (1 x ULN less than ALT less than 2 x ULN ) HBeAg-positive and HBeAg-negative chronic hepatitis B (CHB) patients, and to explore the influence of the age and HBV DNA level to liver pathology in different HBeAg status patients.
Methods
All the patients who met the inclusion criteria form "eleventh five-year plan" National Science and Technology Major Project, the treatment program of integrative traditional and western medicine for CHB were enrolled in this study between October 2009 and March 2011 .B type ultrasound-guided liver biopsy was carried out in all patients and hepatitis B surface antigen (HBsAg) , HBeAg titer as well as HBV DNA level were detected at the same time. Hepatic tissue inflammation and fibrosis degree of patients according to HBeAg-positive and negative, age ( more than or equal to 40 years and less than 40 years), HBV DNA level (more than or equal to 10^5copy/ml and less than l0^5 copy/ml) were compared respectively. Chi-square test was used to compare the constitute percentage between the two samples. Multivariate logistic regression analysis was also performed to evaluate the correlation between different factors.
Results
There were no significant difference in the grade of liver inflammation and the stage of liver fibrosis between 389 HBeAg positive and 126 HBeAg-negative patients (X2=4.326 and X2=3.464, respectively, P values were all more than 0.05). In the group of patients with age less than 40 years, the distribution of different liver inflammation and fibrosis had no significant difference between HBeAg-positive and negative patients (X2=2.543 and X2=5.024, respectively, P values were all more than 0.05). In the group of patient with age more than or equal to 40 years, the percentage of moderate and severe inflammation (G3, G4) HBeAg-positive patients(32.9%) owned is much higher than that of HBeAg-negative patients(16.4%), X2=8.777, P less than 0.05.But the stage of liver fibrosis in HBeAg-positive patients was not significantly different than that of HBeAg-negative ones (X2=0.977, P more than 0.5). In the group of patients with HBV DNA more than or equal to 10^5copy/ml, the percentage of mild inflammation in HBeAg-positive patients (17.5%) was much high than that of HBeAg-negative patients(7.3%), X2=8.851, P less than 0.05. The stage of liver fibrosis between HBeAg-positive and negative patients was no significant difference (X2=8.227, P more than 0.05). In the patients with HBV DNA less than 10^5 copy/ml, The percentage of HBeAg-negative patients(29.6%) with mild inflammation(G1) was much higher than HBeAg-positive patients (6.9%), X2=6.357, P less than 0.05. There was no significant difference in the stage of liver fibrosis between HBeAg-positive and negative patients (X2=4.061, P more than 0.05). The results of multivariate logistic regression analysis showed that age was the independent risk factor for different degree of liver inflammation and fibrosis seriousness.
Conclusion
The status of HBeAg has no association with the grade of liver inflammation and the stage of liver fibrosis in CHB patients with mildly elevated ALT. The percentage of moderate and severe inflammation in the HBeAg-positive patients with age more than or equal to 40 years was significantly elevated. The grade of liver inflammation has significant difference between HBeAg-positive and negative patients with different HBV DNA levels as well.

肝胆速递

中华肝脏病杂志。 2012五月20（5）:348-52。 DOI：10.3760/cma.j.issn.1007-3418.2012.05.009。
[HBeAg阳性和HBeAg阴性的慢性乙肝患者ALT轻度升高的肝组织病理特征。
[中文]
刘SQ，朱XJ，孙XH，李明，高YQ。
源

上海繁体中国医药大学，上海，中国的杂志，。
抽象

轻度ALT升高（1×ULN低于ALT小于2 x ULN）的HBeAg阳性和HBeAg阴性慢性乙型肝炎（CHB）患者，并探讨影响的年龄和HBV DNA分析现场的病理特征水平在不同HBeAg状态患者的肝组织病理变化。 B型超声方法2009年10月至2011年3月在这项研究中所有患者符合纳入标准，形成“十一五计划”国家科学技术重大项目，为一体的中西医结合的治疗方案的CHB患者。引导下肝穿刺活检进行，所有患者和乙肝表面抗原（HBsAg），e抗原滴度的检测HBV DNA水平在同一时间。根据患者的肝组织炎症和纤维化程度的HBeAg阳性和阴性，年龄（大于或等于40岁和小于40岁），HBV DNA水平（大于或等于10 ^ 5copy/ml和小于10 ^ 5拷贝/ ml）分别比较了。卡方检验用来比较两个样本之间的构成比例。多因素Logistic回归分析，以评估不同因素之间的相关性。结果有档次的肝脏炎症和纤维化分期之间389 126 HBeAg阳性和HBeAg阴性患者（无显着差异，X2 = 4.326，X2 = 3.464，P值均大于0.05）。在年龄小于40岁的患者组，分配不同的肝组织炎症和纤维化之间的HBeAg阳性和阴性的患者（X2 = 2.543，X2 = 5.024，没有显着性差异，P值均大于0.05） 。在组病人年龄大于或等于至40岁，中度和重度炎症（G3，G4）的HBeAg阳性患者（32.9％）拥有的百分比远高于HBeAg阴性患者（16.4％）， ，X2 = 8.777，P小于0.05.But比HBeAg阴性的（X2 = 0.977，P大于0.5）的HBeAg阳性患者肝纤维化的阶段并没有显着不同的。在组患者的HBV DNA大于或等于10 ^ 5copy/ml，轻度炎症的比例在HBeAg阳性患者（17.5％）显着高于HBeAg阴性患者（7.3％），X2 = 8.851，P小于0.05。阶段HBeAg阳性和阴性患者的肝纤维化之间没有显着性差异（χ2= 8.227，P大于0.05）。在患者的HBV DNA小于10 ^ 5拷贝/ ml，HBeAg阴性患者的比例（ 29.6％），轻度炎症（G1）显着高于HBeAg阳性患者（6.9％），X2 = 6.357，P小于0.05。有肝纤维化的阶段，HBeAg阳性和阴性的患者（X2 = 4.061，P大于0.05）之间没有显着差异。多因素logistic回归分析结果表明，年龄是独立的危险因素不同程度的肝组织炎症和纤维化的严重性。结论HBeAg的状态没有任何关联，同档次肝组织炎症和轻度ALT升高的慢性乙型肝炎患者肝纤维化的阶段。在HBeAg阳性患者，年龄大于或等于至40岁的中度和重度炎症的比例显着升高。肝组织炎症的等级有不同的HBV DNA水平和HBeAg阳性和阴性患者的显着区别。

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