| ALT正常或轻度升高的E抗原阳性慢性乙型肝炎住院患者肝组织METAVIR评分特征分析 |
| Alternative Title | Changes of hepatic histology from patients with chronic hepatitis B with HBeAg positive and normal or minimally raised alanine aminotransferase
|
| 赵灵芝 |
| Thesis Advisor | 张岭漪
; 王祥
|
| 2015-05-19
|
| Degree Grantor | 兰州大学
|
| Place of Conferral | 兰州
|
| Degree Name | 硕士
|
| Keyword | HBeAg
慢性乙型肝炎
丙氨酸转氨酶
METAVIR评分
|
| Abstract | 目的：分析ALT正常或轻度升高的HBeAg（+）CHB患者肝组织METAVIR评分特征。
方法：对ALT正常或轻度升高HBeAg（+）CHB患者资料进行分析。
结果：（1）男：女=2.16：1；（2）30-40岁组32.5%；（3）血清ALT≤1ULN组57.3%，血清1ULN＜ALT＜2ULN组42.7%；（4）血清HBV-DNA载量低于检测下限者占11.1%，血清HBV-DNA＜E+5copies/ml组20.5%，血清HBV-DNA≥E+5copies/ml组68.4%；（5）13例血清HBV-DNA低于检测值下限者中，76.9%患者肝组织HBV-DNA存在复制；（6）HBsAg＜2500IU/ml组25.5%，HBsAg≥2500IU/ml组74.5%；（7）Fibroscan＜5kPa组20.6%，Fibroscan≥5kPa组79.4%；（8）肝组织METAVIR评分特征及相关性：G2以上47.9%，S2以上45.3%，呈正相关；（9）性别与METAVIR≥G2S2比较无差异；（10）40岁以上组炎症重于40岁以下组，纤维化无差别；（11）血清ALT水平与METAVIR≥G2S2比较无差异；（12）HBV-DNA载量与METAVIR≥G2S2比较无差异；（13）血清HBsAg滴度与METAVIR≥G2S2相关性：HBsAg＜2500IU/ml组与HBsAg≥2500IU/ml组在G2-4差异有统计学意义，在S2-4间无差异；（14）FS与METAVIR评分呈显著正相关。
结论：1.男性多于女性，年龄较轻，HBV-DNA呈高载量，HBsAg滴度较高；2.50%以上的患者METAVIR评分≥G2S2；3.40岁以上、HBsAg滴度较低者发生炎性损伤的可能性较大，不反映纤维化程度；4.血清HBV-DNA低于检测下线但肝组织HBV-DNA仍有复制；5. 血清HBV-DNA/肝组织HBV-DNA载量可能不是影响患者METAVIR评分≥G2S2的直接因素；6. Fibroscan值可作为评估慢性HBV感染者病情进展的一个参考因素。 |
| Other Abstract | OBJECTIVE: To Analysis the changes of hepatic histology from patients with chronic hepatitis B with HBeAg positive and normal or minimally raised alanine aminotransferase.
METHODS: A prospective study was conducted the patients with chronic hepatitis B with HBeAg positive and normal or minimally raised alanine aminotransferase, who were admitted to the Lanzhou University Second Hospital for a liver biopsy.RESULTS: CHB patients (n=117)who were admitted to the Lanzhou University Second Hospital for a liver biopsy were enrolled.(1)Gender distribution:68.4%(80/117)of whom were male,31.6%(37/117)of whom were female,Male: female = 2.16:1;Male had twice as many female who infected HBV;(2)Age distribution: The age beween 30-40 have highest proportion, which accounting for 32.5% (38/117); (3)Serum ALT level distribution: The serum ALT lever less than ULN accounted for 57.3% (67/117);The serum ALT lever less than twice ULN accounted for 42.7%(50/117);(4) Serum hepatitis B virus (HBV)-DNA level:The serum HBV-DNA level less than 5.0E+2copies/ml accounted for 11.1%(13/117);The serum HBV-DNA level less than E+5copies/ml accounted for 20.5%(24/117);The serum HBV-DNA level more than E+5copies/ml accounted for 68.4%(80/117);More than 50% patients have high viral loads;(5)The liver tissue HBV-DNA level: HBeAg-positive patients(n=13)whose serum HBV-DNA level less than 5.0E+2copies/ml have 76.9% HBV-DNA in liver tissue, and 46.2% have high viral loads in these patients;(6)HBsAg concentration:Patients with HBsAg concentrations less than 2500IU/ml accounted for 25.5%(12/47),and HBsAg concentrations between 2500IU/ml and 10000 IU/ml accounted for 25.5%(12/47),and HBsAg concentrations more than 10000 IU/ml accounted for 48.9% (23/47);The last group take highest proportion;(7)Fibroscan distribution:Liver stiffness measurement(LSM)by Fibroscan less than 5kPa accounted for 20.6%(22/107),and more than 5kPa accounted for 79.4%(85/107).The last group take highest proportion;(8)The characteristic of hepatic histopathology and correlation between inflammaiton grade and fibrosis stage score:Significant hepatic inflammation was found in 47.9%(56/117)of these patients,and significant hepatic fibrosis was found in 45.3%(53/117);There was a positive correlation between inflammaiton grade and fibrosis stage score(r=0.803,P<0.01);(9)The correlation between gender and METAVIR scoring≥G2S2:There was no statistically significant difference in sex raito bewteen the two groups(P>0.05);(10)The c... |
| URL | 查看原文
|
| Language | 中文
|
| Document Type | 学位论文
|
| Identifier | https://ir.lzu.edu.cn/handle/262010/224238
|
| Collection | 学院待认领
|
| Affiliation | 临床医学院
|
Recommended Citation
GB/T 7714 |
赵灵芝. ALT正常或轻度升高的E抗原阳性慢性乙型肝炎住院患者肝组织METAVIR评分特征分析[D]. 兰州. 兰州大学,2015.
|
Items in the repository are protected by copyright, with all rights reserved, unless otherwise indicated.
