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目的分析乙型肝炎病毒(HBV)感染和血吸虫感染对肝纤维化的影响。方法肝纤维化脾大脾亢患者59例,取肝组织进行肝纤维化病理分期并查肝组织血吸虫虫卵;采用酶联免疫吸附试验(ELISA)检测血清乙肝两对半,同时观察患者临床症状及实验室指标包括血常规、肝功能及血清胶原蛋白(HA),血小板转化生长因子BB(PDGF-BB)和金属蛋白酶组织抑制因子1(TIMP-1)水平。分析乙肝阳性与乙肝阴性肝纤维化患者之间,肝组织血吸虫虫卵阳性与虫卵阴性肝纤维化患者之间的肝纤维化程度、临床及实验室检查指标的差异,并分析影响肝纤维化程度的相关因素。结果乙肝肝纤维化患者肝功能显著异常,其血清HA和PDGF-BB分别为(1.03±0.35)ng/ml和(0.31±0.04)ng/ml,与单纯血吸虫病肝纤维化患者的(0.69±0.20)ng/ml和(0.11±0.03)ng/ml比较差异均有统计学意义(P<0.01)。肝组织虫卵阴、阳性患者间的肝纤维化程度差异无统计学意义(χ2=2.266,P>0.05);肝纤维化严重程度与乙肝感染相关(B=0.382,P<0.05),与肝脏血吸虫虫卵数无相关性(P>0.05)。结论乙肝比血吸虫病对肝纤维化的影响更严重,临床上应先确定肝纤维化的病因,以指导临床治疗。
Objective To analyze the influence of hepatitis B virus (HBV) infection and schistosomiasis infection on hepatic fibrosis. Methods Fifty-nine patients with splenomegaly and hypersplenism of liver fibrosis were divided into two groups according to the pathological stage of hepatic fibrosis and liver tissue schistosomiasis. The serum hepatitis B was detected by enzyme-linked immunosorbent assay (ELISA) The laboratory parameters included blood, liver function, serum levels of HA, PDGF-BB and TIMP-1. Analysis of hepatitis B-positive and hepatitis B-negative patients with liver fibrosis, liver tissue Schistosoma japonicum egg-positive and egg-negative liver fibrosis in patients with liver fibrosis, clinical and laboratory test indicators differences, and analyze the impact of liver fibrosis Relevant factors of the degree. Results The liver function of patients with hepatitis B liver fibrosis was significantly abnormal. The serum HA and PDGF-BB levels were (1.03 ± 0.35) ng / ml and (0.31 ± 0.04) ng / ml, respectively, which were significantly higher than those in schistosomiasis patients with liver fibrosis 0.20) ng / ml and (0.11 ± 0.03) ng / ml, respectively (all P <0.01). There was no significant difference in the degree of hepatic fibrosis between the positive and negative patients (χ2 = 2.266, P> 0.05). The severity of liver fibrosis was associated with hepatitis B infection (B = 0.382, P <0.05) Schistosome eggs had no correlation (P> 0.05). Conclusion Hepatitis B than schistosomiasis more serious impact on liver fibrosis, the clinical should first determine the cause of liver fibrosis to guide clinical treatment.