当前位置:文档之家› 慢性乙型肝炎与慢性丙型肝炎患者临床和肝组织病理学特征分析

慢性乙型肝炎与慢性丙型肝炎患者临床和肝组织病理学特征分析

··实用肝脏病杂志2019年3月第22卷第2期J Prac Hepatol ,Mar.2019.Vol.22No.2

慢性乙型肝炎与慢性丙型肝炎患者临床和肝组织

病理学特征分析

蒋奕,刘冰

【摘要】目的

分析慢性乙型肝炎(CHB )与慢性丙型肝炎(CHC )患者临床特征及肝组织病理学表现的差异。方法

2013年~2017年我院诊治的CHB 患者300例和CHC 患者100例,收集临床资料并行肝活检组织病理学检查。结果本组资料显示,CHC 患者年龄显著大于【(47.6±12.8)岁对(36.3±9.7)岁】、病程显著长于【(13.1±0.9)年对(6.2±1.8)年】、基础疾病显著多于(39.0%对18.7%)、经血感染显著多于(63.0%对36.7%)、母婴传播显著少于(3.0%对29.7%)、吸毒感染显著多于(40.0%对7.0%)和性传播显著少于(14.0%对26.7%)CHB 患者(P <0.05);CHB 患者血清ALT 水平为(76.5±10.8)U/L ,AST 水平为(111.2±21.3)U/L ,与CHC 患者的【(105.2±20.8)U/L 和(98.3±20.1)U/L 】比,差异显著(P <0.05);CHC 患者肝组织炎症分级>G2者为83.0%,显著高于CHB 患者的48.7%(P <0.05),而肝纤维化分期>S2者为65.0%,也显著高于CHB 患者的28.3%(P <0.05)。结论

CHC 患者由于病程长,发病隐匿,肝组织损伤更明显,需要积极的治疗。

【关键词】慢性乙型肝炎;慢性丙型肝炎;临床特征;组织病理学

DOI :10.3969/j.issn.1672-5069.2019.02.009

Comparison of clinical features and histopathological activity index between patients with chronic hepatitis B and chronic hepatitis C

Jiang Yi ,Liu Bing.Department of Infectious Diseases ,404TH Hospital ,Second Affiliated Hospital ,North Sichuan Medical College ,Mianyang 621000,Sichuan Province ,China 【Abstract 】Objective To compare the clinical and histopathological features in patients with chronic

hepatitis B (CHB )and chronic hepatitis C (CHC ).Methods The clinical data of 300patients with CHB and 100patients with CHC in our hospital between 2013and 2017were collected and analyzed retrospectively.The liver biopsies were performed in all the cases.Results

The materials in our series indicated that the age was older 【(47.6±12.8)yr vs.(36.3±9.7)yr 】,the illness period was longer 【(13.1±0.9)yr vs.(6.2±1.8)yr 】,underlying disease was more multiple (39.0%vs.18.7%),blood-borne infection was more common (63.0%vs.36.7%),mother-to-infant vertical transmission was more less (3.0%vs.29.7%),intravenous infection was more common (40.0%vs.7.0%)and sexual transmitted infection was more less (14.0%vs.26.7%)than in patients with CHB (P <0.05);serum ALT level was (76.5±10.8)U/L and serum AST level was (111.2±21.3)U/L in patients with CHB ,significantly different as compared to 【(105.2±20.8)U/L and (98.3±20.1)U/L 】in patients with CHC (P <0.05);the hepatic histopathological examination showed that >G2hepatic activity (HAI )index in patients with

CHC was 83.0%,much higher than 48.7%(P <0.05)in patients with CHB ,and >S2liver fibrosis was 65.0%,also significantly higher than 28.3%(P <0.05)in patients with CHB.Conclusion There are many clinical and histopathological differences between patients with CHC and with CHB ,and severe liver injuries and fibrosis might be more common in patients with CHC due to longer infection periods ,which needs more medical interventions.【Key words 】Chronic hepatitis B ;Chronic hepatitis C ;Clinical features ;Hepatic activity index ;Liver fibrosis

·病毒性肝炎·

作者单位:621000四川省绵阳市川北医学院第二附属医院/

绵阳404医院感染病科

第一作者:蒋奕,女,39岁,医学硕士,副主任医师。E-mail :453290547@https://www.doczj.com/doc/fe11110863.html, 慢性乙型肝炎(chronic hepatitis B ,CHB )和慢性丙性肝炎(chronic hepatitis C ,CHC )在我国系常

见的传染性肝病[1,2],患者肝组织易出现炎症反应和

纤维化[3]。相关指南指出,对肝组织纤维化或是炎症

反应超过2期或2级时,需实施抗病毒治疗,而对肝组织纤维化或炎症反应较轻者,是否实施抗病毒治疗则需要观察血清病毒载量和血清丙氨酸氨基188

相关主题
相关文档 最新文档