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目的分析现阶段慢性乙型肝炎患者肝脏组织病理学特点。方法对281例慢性乙型肝炎住院患者不同肝脏组织学病变程度与血液生化、乙型肝炎病毒标志物等临床实验室检查指标以及腹部超声检查进行对比分析。结果肝脏不同炎症活动度组中,各组间的平均年龄有显著差异;G1与G3、G2与G3组的外周血白细胞和血小板计数有显著差异;G1与G2、G3组的血清谷氨酸氨基转移酶有显著差异;G1、G2、G3组的腹部超声检查有显著差异。肝脏不同纤维化程度组中,S1、S2与S3、S4组的平均年龄有显著差异;S1、S2与S4组的外周血白细胞计数有显著差异;S1、S2与S3和S4的血小板计数和腹部超声检查有显著差异。未观察到肝脏不同炎症活动度组和肝脏不同纤维化组在HBeAg状态、HBV DNA水平和A/G比例之间存在显著差异。结论慢性乙型肝炎患者肝脏组织病理学改变与血常规、肝脏功能及肝脏影像学检查结果一致,而与血清乙型肝炎病毒抗原状态和病毒血症严重程度无明显相关。与未采用抗乙型肝炎病毒药物时期和乙型肝炎病毒耐药突变株出现之前相比,现阶段慢性乙型肝炎患者肝脏组织病理学特点未发生明显变化。慢性乙型肝炎患者肝脏组织病理学检查具有临床价值,应予以重视。
Objective To analyze the histopathological features of liver in patients with chronic hepatitis B at the present stage. Methods 281 cases of chronic hepatitis B inpatients with different liver histological lesions and blood biochemistry, hepatitis B virus markers and other clinical laboratory tests and abdominal ultrasound contrast were analyzed. Results There were significant differences among different groups in the activity of liver inflammation group. There were significant differences in the count of peripheral blood leukocytes and platelets between G1 and G3, G2 and G3 groups; There were significant differences in transferase; G1, G2, G3 group of abdominal ultrasound examination were significantly different. The average age of S1, S2 and S3, S4 groups were significantly different in different degrees of liver fibrosis group. There were significant differences in peripheral white blood cell count between S1, S2 and S4 groups. Platelet counts of S1, S2, S3 and S4 and abdomen There are significant differences in ultrasound examination. No significant differences in HBeAg status, HBV DNA level and A / G ratio were observed between the different activity groups of liver inflammation and different liver fibrosis groups. Conclusion The histopathological changes of liver in patients with chronic hepatitis B are consistent with the results of blood routine examination, liver function and liver imaging examination, but not with the serum hepatitis B virus antigen status and the severity of viremia. Compared with those before the advent of anti-hepatitis B virus drugs and hepatitis B virus-resistant mutants, there was no significant change in the histopathological features of liver in patients with chronic hepatitis B at this stage. Chronic hepatitis B patients with liver histopathology has clinical value, should be taken seriously.