脂肪肝和转氨酶的乙肝病毒感染者的标高抗HBe抗原消极和病

StephenW

Medicine (Baltimore). 2016 Apr;95(17):e3565.
Relationship Between Hepatic Steatosis and the Elevation of Aminotransferases in HBV-Infected Patients With HBe-Antigen Negativity and a Low Viral Load.Enomoto H1, Aizawa N, Nishikawa H, Ikeda N, Sakai Y, Takata R, Hasegawa K, Nakano C, Nishimura T, Yoh K, Ishii A, Takashima T, Iwata Y, Iijima H, Nishiguchi S.
Author information

• 1From the Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
  

AbstractNonalcoholic fatty liver disease has been suggested to be associated with alanine aminotransferase (ALT) elevation in hepatitis B virus (HBV)-infected patients with HBe antigen (HBeAg)-negativity and a low HBV-DNA level. However, few studies have evaluated the association according to histological findings of the liver.Among a total of 198 HBV-infected patients who received a percutaneous liver biopsy, we studied the histological and laboratory findings of HBeAg-negative patients without receiving nucleoside/nucleotide analogues treatment (N = 70) in order to evaluate whether hepatic steatosis and its related metabolic disorders were associated with an elevation in ALT levels in HBeAg-negative patients.In HBeAg-negative patients with a high serum HBV-DNA level (≥2000 IU/mL), the level of HBV-DNA was the only significant factor related to ALT elevation. However, in HBeAg-negative patients with a low HBV-DNA level, the serum ferritin level, and histologically observed hepatic steatosis were significantly associated factors with ALT elevation. When we evaluated 2 metabolic variables (serum ferritin and fasting insulin) that are suggested to be relevant to the presence of progressive disease in Japanese patients, we found that the rate of metabolic disorders was significantly higher among patients with a high ALT level and a low HBV-DNA level than it was among those with other conditions. The triglyceride level and the frequency of moderate or severe hepatic steatosis were significantly higher in patients with a low HBV-DNA level than in those with a high HBV-DNA level.Histologically proven hepatic steatosis and its related metabolic disorders are suggested to be involved in the elevation of aminotransferases of HBeAg-negative patients, particularly those with low HBV-DNA levels.

StephenW

医学（巴尔的摩）。 2016年4月; 95（17）：e3565。
脂肪肝和转氨酶的乙肝病毒感染者的标高抗HBe抗原消极和病毒载量低的关系。
榎本H1，相泽N，西川H，池田N，酒井Y，高田R，长谷川K，中野C，西村T，Yoh公司K，石井A，高岛T，岩田Y，饭岛H，西口S.
作者信息

    1从肝胆胰疾病，内科，医学学院兵库县西宫，兵库县，日本的分部。

抽象

非酒精性脂肪肝疾病已建议要与乙型肝炎病毒（HBV）感染患者抗HBe抗原（HBeAg）-negativity和低HBV-DNA水平丙氨酸转氨酶（ALT）升高相关联。然而，很少有研究根据liver.Among的组织学结果评估协会共有198 HBV感染的病人谁收到了经皮肝穿刺活检，我们研究HBeAg阴性患者的病理和实验室检查结果没有收到核苷/核苷酸类似物治疗（N = 70），以评估是否肝脂肪变性和其相关的代谢性疾病，用ALT水平的正视HBeAg阴性patients.In HBeAg阴性患者具有高血清HBV-DNA水平有关（≥2000IU /毫升），HBV-DNA的水平有关ALT升高的唯一显著因素。然而，在HBeAg阴性患者与低HBV-DNA水平，血清铁蛋白水平，组织学观察脂肪肝有显著相关因素与ALT升高。当我们评价被建议是有关在日本患者疾病进展的存在2代谢变量（血清铁蛋白和空腹胰岛素），我们发现，代谢紊乱率为患者显著高于具有高ALT水平和低HBV-DNA水平比它的那些与其他条件中。甘油三酯水平和中度或重度肝脂肪变性的频率分别在患者显著高于比那些具有高HBV-DNA level.Histologically证明肝脂肪变性和其相关的代谢性疾病的低HBV-DNA水平被建议涉及HBeAg阴性患者，特别是那些具有低的HBV-DNA水平的转氨酶的标高。