低水平HBsAg慢性乙型肝炎患者炎症分级及纤维化分期观察

肝脏 ›› 2022, Vol. 27 ›› Issue (2): 225-227.

低水平HBsAg慢性乙型肝炎患者炎症分级及纤维化分期观察

肖珊珊, 杨巧红, 李建婷

510405 广东广州中医药大学第一附属医院病理科(肖珊珊);广州中医药大学基础医学院病理教研室(杨巧红),微生物教研室(李建婷)

收稿日期:2021-04-19 出版日期:2022-02-28 发布日期:2022-04-19
基金资助:
广东省中医药局科研项目(20211122)

Observation of inflammation grade and fibrosis stage in chronic hepatitis B patients with low level of HBsAg

XIAO Shan-shan¹, YANG Qiao-hong², LI Jian-ting³

1. Department of Pathology, the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangdong 510405, China;
2. Department of Pathology,
3. Department of Microbiology, College of Basic Medicine, Guangzhou University of Chinese Medicine, Guangdong 510006, China

Received:2021-04-19 Online:2022-02-28 Published:2022-04-19

摘要/Abstract

摘要： 目的观察低水平HBsAg慢性乙型肝炎(CHB)患者炎症分级及纤维化分期的特征。方法选取2018年5月至2020年5月广州中医药大学第一附属医院和南方医院低水平HBsAg CHB患者157例。所有患者入院后均在治疗前接受肝穿刺活检及血清HBsAg、HBV DNA、血小板(PLT)、总胆红素(TBil)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)检查。分析不同炎症活动程度分级、纤维化分期患者间上述血清指标的差异,采用Spearman秩相关分析PLT与低水平HBsAg CHB患者纤维化分期间的相关性。结果 157例CHB患者中炎症活动程度分级:G1级43例、G2级56例、G3级40例、G4级18例;纤维化分期:S1期44例、S2期53例、S3期42例、S4期18例。不同炎症活动程度分级患者HBsAg、HBV DNA、PLT、TBil、ALT、AST水平对比,差异均无统计学意义(P＞0.05)。不同纤维化分期患者HBsAg、HBV DNA、TBil、ALT、AST水平对比,差异均无统计学意义(P>0.05);纤维化S1、2、3、4期患者PLT水平分别为(214.15±24.16)×10⁹/L、(174.26±15.06)×10⁹/L、(144.75±10.46)×10⁹/L、(130.76±5.56)×10⁹/L,不同纤维化分期患者PLT对比结果为S1＞S2＞S3＞S4,差异有统计学意义(P<0.05)。经相关性分析证实PLT与低水平HBsAg CHB患者纤维化分期呈负相关(r=-0.516,P<0.05)。结论低水平HBsAg CHB患者仍存在肝组织炎症与纤维化,经相关性分析证实PLT水平与纤维化分期关系密切。

关键词: 慢性乙型肝炎, 乙型肝炎表面抗原, 炎症, 纤维化, 肝穿刺活检

Abstract: Objective To observe the characteristics of inflammation grade and fibrosis stage in patients with chronic hepatitis B (CHB) with low level of hepatitis B surface antigen (HBsAg). Methods We selected 157 cases of low level of HBsAg in CHB patients from May 2018 to May 2020, all patients admitted to hospital after receiving liver biopsy before treatment, serum HBsAg and HBV DNA, platelet (PLT), total bilirubin (TBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST) examination. According to the liver puncture results, the differences of the above serum indexes among patients with different grades of inflammatory activity and fibrosis stages were analyzed. Finally, Spearman rank correlation analysis was used to test the correlation between serum PLT and the fibrotic grading period of CHB patients with low HBsAg levels. Results Among 157 CHB patients, the inflammatory activity grades of 43 cases were G1 grade, 56 cases were G2 grade, 40 cases were G3 grade, and 18 cases were G4 grade. Fibrosis stages of 44 cases were S1 stage, 53 cases with S2 stage, 42 cases with S3 stage, and 18 cases with S4 stage. Comparison of levels of HBsAg, HBV DNA, PLT, TBIL, ALT and AST in patients with different grades of inflammatory activity (P>0.05). The levels of HBsAg, HBV DNA, TBIL, ALT and AST in patients with different fibrosis stages were compared (P>0.05). PLT levels in patients with fibrosis stage S1, 2, 3 and 4 were (214.15 ± 24.16) × 10⁹/L, (174.26 ± 15.06) × 10⁹/L, (144.75 ± 10.46) × 10⁹/L, (130.76 ± 5.56) × 10⁹/L, respectively. PLT levels in patients with different fibrosis stages were S1 > S2 > S3 > S4 (P<0.05). The correlation analysis confirmed that PLT was negatively correlated with fibrosis stage in CHB patients with low level of HBsAg (P<0.05). Correlation analysis confirmed that PLT was negatively correlated with fibrosis stage in CHB patients with low HBsAg level (r=-0.516, P<0.05). Conclusion CHB patients with low HBsAg level still had liver tissue inflammation and fibrosis, and the correlation analysis confirmed that PLT level was closely related to fibrosis stage, clinicians should pay attention to it.

Key words: Chronic hepatitis B, Hepatitis B surface antigen, Inflammation, Fibrosis, Liver biopsy

肖珊珊, 杨巧红, 李建婷. 低水平HBsAg慢性乙型肝炎患者炎症分级及纤维化分期观察[J]. 肝脏, 2022, 27(2): 225-227.

XIAO Shan-shan, YANG Qiao-hong, LI Jian-ting. Observation of inflammation grade and fibrosis stage in chronic hepatitis B patients with low level of HBsAg[J]. Chinese Hepatolgy, 2022, 27(2): 225-227.

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