HBV DNA低水平患者的肝组织炎症活动度及相关因素分析

刘立; 刘春云; 杜映荣; 黄红丽; 陈洁; 罗煜; 李惠敏; 李卫昆; 李俊义; 岳云璇

doi:10.3969/j.issn.1001-5256.2019.01.014

HBV DNA低水平患者的肝组织炎症活动度及相关因素分析

DOI: 10.3969/j.issn.1001-5256.2019.01.014

1. 云南省昆明市第三人民医院肝三科
2. 云南省昆明市第三人民医院内科
3. 云南省昆明市第三人民医院药剂科

基金项目:

云南省科技厅应用基础研究项目(2017FH001-088)；昆明市科技局科技计划项目(2017KJJH252)；

详细信息

中图分类号: R512.62;R575
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出版历程
- 收稿日期: 2018-08-16
- 出版日期: 2019-01-20

Liver inflammatory activity in chronic hepatitis B patients with a low HBV DNA level and related factors

Third Department of Hepatology, The Third People's Hospital of Kunming

Research funding:

摘要

摘要: 目的分析低水平HBV DNA患者肝组织炎症活动度与临床特征间的关系,为低水平HBV DNA患者的病情判断提供依据。方法收集2014年1月-2017年12月在云南省昆明市第三人民医院治疗HBV DNA水平低于2000 IU/ml且高于20 IU/ml患者137例,根据炎症活动分级分为G1组（n=44）、G2组（n=84）和G3组（n=9）。所有患者均进行肝穿刺活组织检查和肝组织免疫组化,分析炎症分级与患者年龄、性别、感染HBV时间、肝功能、HBsAg水平、HBV DNA载量、基因型、门静脉内径、脾静脉内径、脾脏厚度等的关系。等级资料多组间比较采用Kruskal-Wallis H检验。结果 137例患者中HBeAg阴性126例,其中G1 42例（33. 33%）,G2 77例（61. 11%）,G3 7例（5. 56%）; HBeAg阳性11例,G1 2例（18. 18%）,G2 7例（63. 64%）,G3 2例（18. 18%）。126例HBeAg阴性患者G1、G2、G3 3组间比较,Glo、HBV DNA、PLT、脾静脉内径和脾脏厚度比较差异均有统计学意义（H值分别为6. 189、7...
- 病毒载量 /
- 炎症活动度 /
- 病理学,临床
Abstract: Objective To investigate the association between liver inflammatory activity and clinical features in chronic hepatitis B (CHB) patients with a low HBV DNA level, and to provide a basis for judging the condition of such patients.Methods A total of 137 patients with an HBV DNA level of 20-2000 IU/ml who were treated in The Third People's Hospital of Kunming from January 2014 to December 2017were enrolled, and according to the grade of liver inflammatory activity, they were divided into G1 group with 44 patients, G2 group with 84patients, and G3 group with 9 patients.Liver biopsy and immunohistochemistry were performed for all patients, and the association of the grade of liver inflammatory activity with age, sex, HBV infection time, liver function, HBsAg level, HBV DNA load, genotype, diameter of the portal vein, diameter of the splenic vein, and spleen thickness was analyzed.The Kruskal-Wallis H test was used for comparison of nonparametric ranked data between multiple groups.Results Of all 137 patients, 126 had negative HBeAg, among whom 42 (33.33%) had G1 inflammation, 77 (61.11%) had G2 inflammation, and 7 (5.56%) had G3 inflammation;11 had positive HBeAg, among whom 2 (18.18%) had G1 inflammation, 7 (63.64%) had G2 inflammation, and 2 (18.18%) had G3 inflammation.There were significant differences in globulin, HBV DNA load, platelet count (PLT) , diameter of the splenic vein, and spleen thickness between the 126 HBeAg-negative patients with different inflammation grades (H=6.189, 7.168, 8.624, 8.170, and 8.522, all P<0.05) .Conclusion The majority of patients with a low HBV DNA level have≥G2 liver inflammation and the indication for antiviral therapy, and the grade of inflammation is closely associated with globulin, HBV DNA load, PLT, diameter of the splenic vein, and spleen thickness.
- viral load /
- inflammation grades /
- pathology, clinical

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