临床肝胆病杂志2024，Vol.40Issue(5)：940-945,6.DOI:10.12449/JCH240512
ALT水平正常的慢性乙型肝炎患者的血清学特征及肝组织病理学分析
Serological features and liver histopathology of chronic hepatitis B patients with normal alanine aminotransferase
摘要
Abstract
Objective To investigate the liver histopathological features of chronic hepatitis B(CHB)patients with normal alanine aminotransferase(ALT)and their correlation with serological markers.Methods Clinical data were collected from 137 patients with normal ALT who were treated in Wuxi Fifth People's Hospital from April 2018 to June 2021,and the differences in liver histopathology and serological markers were analyzed,as well as the correlation between liver histopathology and serological markers.The chi-square test was used for comparison of categorical data between groups,and the Kruskal-Wallis H test was used for comparison of data between multiple groups.A Spearman rank correlation test was performed,and logistic regression was used to perform the multivariate analysis.Results In the ALT≤20 U/L,20—29 U/L,and 30—40 U/L groups,the patients with significant inflammatory necrosis(≥G2)accounted for 57.4%,53.4%,and 75%,respectively,and the patients with significant fibrosis(≥S2)accounted for 63.8%,62.1%,and 75%,respectively.There was a significant difference in the degree of inflammatory necrosis between the patients with positive or negative HBeAg,the patients with different levels of serum HBV DNA,and the patients with different levels of serum HBV RNA(χ2=10.008,6.911,and 7.946,all P<0.05),and there was a significant difference in fibrosis stage between the patients with positive or negative HBeAg and the patients with different levels of serum HBV RNA(χ2=7.996 and 10.874,both P<0.05).The degree of liver inflammation and fibrosis stage were not significantly correlated with serum HBV DNA(rs=0.024,P=0.785;rs=0.039,P=0.652),while they were significantly correlated with serum HBV RNA(rs=0.222,P=0.009;rs=0.187,P=0.029).The multivariate analysis showed that in CHB patients,positive HBeAg was an independent risk factor for inflammatory necrosis(odds ratio[OR]=-0.302,95%confidence interval[CI]:-1.160 to 0.386,P=0.002)and fibrosis(OR=-0.387,95%CI:-1.160 to 0.386,P=0.011).Conclusion There are varying degrees of inflammatory necrosis and fibrosis in the liver of CHB patients with normal ALT,and positive HBeAg is independent risk factor for significant inflammatory necrosis and fibrosis in liver tissue of these patients.关键词
乙型肝炎病毒/丙氨酸转氨酶/HBV DNA/HBV RNA/病理学Key words
Hepatitis B virus/Alanine Transaminase/HBV DNA/HBV RNA/Pathology引用本文复制引用
刘珊珊,陆忠华..ALT水平正常的慢性乙型肝炎患者的血清学特征及肝组织病理学分析[J].临床肝胆病杂志,2024,40(5):940-945,6.基金项目
无锡市医学重点学科建设项目-创新团队(CXTD2021009) （CXTD2021009）
太湖人才计划(20200803) Wuxi Medical Key Discipline Construction Project-Innovation Team(CXTD2021009) （20200803）
Taihu Talent Program(20200803) （20200803）
