脾脏厚度可以预测慢性乙型肝炎患者的肝脏病理学显着，丙

StephenW

J Int Med Res. 2018 Sep 13:300060518796760. doi: 10.1177/0300060518796760. [Epub ahead of print]
Spleen thickness can predict significant liver pathology in patients with chronic hepatitis B with persistently normal alanine aminotransferase or minimally raised alanine aminotransferase: a retrospective study.
Zhang J1, Du X1, Zhou Z1, Lv F1, Yu Y1.
Author information

1
    Department of Infectious Diseases, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

Abstract

Objective Liver biopsy is the gold standard test for assessment of liver pathology. This study was performed to assess the predictive value of spleen thickness for liver pathology and the role of routine follow-up procedures in significant liver pathology for patients with chronic hepatitis B (CHB) with persistently normal alanine aminotransferase (PNALT) or minimally raised alanine aminotransferase (ALT). Methods Patients with CHB who underwent percutaneous liver biopsy were retrospectively reviewed. The relationship of liver pathology with age, ALT, hepatitis B e-antigen, and spleen thickness was statistically analyzed, and the predictive accuracy of spleen thickness was evaluated. Results In total, 80.65% of patients had significant necroinflammation and/or fibrosis. Nearly 60% of patients had splenomegaly, of which 89.12% had a histopathological grade of ≥G2 and/or S2. Spleen thickness was predictive of liver pathology, and significant histological findings increased as the hepatitis B virus (HBV) DNA level increased. Conclusions Spleen thickness is an effective predictor of liver pathology in patients with PNALT or minimally raised ALT. Additionally, the prevalence of significant histological findings tended to increase as the HBV DNA level increased. Patients with CHB and splenomegaly and a high HBV DNA level should be treated early with antivirals to improve liver pathology.
KEYWORDS:

Chronic hepatitis B (CHB); HBV DNA; fibrosis; necroinflammation; persistently normal alanine aminotransferase (PNALT); significant liver histopathology; spleen thickness

PMID:
    30213226
DOI:
    10.1177/0300060518796760

StephenW

J Int Med Res。 2018年9月13日：300060518796760。 doi：10.1177 / 0300060518796760。 [提前打印]
脾脏厚度可以预测慢性乙型肝炎患者的肝脏病理学显着，丙氨酸氨基转移酶持续正常或丙氨酸氨基转移酶水平升高：一项回顾性研究。
Zhang J1，Du X1，Zhou Z1，Lv F1，Yu Y1。
作者信息

1
    浙江大学医学院邵逸夫医院传染病科，杭州，中国。

抽象

目的肝脏活检是评估肝脏病理学的金标准试验。本研究旨在评估脾脏厚度对肝脏病理学的预测价值以及常规随访程序在慢性乙型肝炎（CHB）患者中的作用，其中慢性乙型肝炎（CHB）患者丙氨酸氨基转移酶持续正常（PNALT）或丙氨酸氨基转移酶微量升高（ALT）。方法回顾性分析接受经皮肝穿刺活检的CHB患者。统计分析肝脏病理与年龄，ALT，乙型肝炎e抗原和脾脏厚度的关系，评价脾脏厚度的预测准确性。结果总共有80.65％的患者出现明显的坏死性炎症和/或纤维化。近60％的患者有脾肿大，其中89.12％的患者的组织病理学分级≥2和/或S2。脾脏厚度可预测肝脏病理，随着乙型肝炎病毒（HBV）DNA水平的增加，显着的组织学发现也会增加。结论脾脏厚度是PNALT或ALT升高患者肝脏病理的有效预测指标。此外，随着HBV DNA水平的增加，显着组织学发现的患病率趋于增加。患有CHB和脾肿大以及高HBV DNA水平的患者应尽早用抗病毒药物治疗，以改善肝脏病理。
关键词：

慢性乙型肝炎（CHB）; HBV DNA;纤维化;坏死性炎症;持续正常的丙氨酸氨基转移酶（PNALT）;显着的肝脏组织病理学;脾脏厚度

结论：
    30213226
DOI：
    10.1177 / 0300060518796760