Li Xiao, Jianchun Xian, Yang Li, Aiwen Geng, Xiuzhen Yang, Libin Han, Hongtao Xu
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引用次数: 12
摘要
本研究旨在评估与肝脏组织学改变相关的因素。回顾性分析157例慢性乙型肝炎患者的肝活检。只有ALB与晚期肝坏死炎症显著相关(P = 0.001)。年龄、ALB、GLOB、AST、PLT和PT是显著纤维化的独立预测因子(P = 0.002, P < 0.001, P = 0.001, P = 0.048, P < 0.001, P = 0.001)。ALT正常患者的AST、WBC、HBV DNA与晚期纤维化显著相关(P < 0.001, P = 0.041, P = 0.012, resp), ALT异常患者的年龄、ALB、GLOB、PLT、PT与晚期纤维化显著相关(P = 0.003, P < 0.001, P = 0.004, P < 0.001, P = 0.002, resp)。年龄、AST、GGT、PLT和PT与HBeAg+患者的晚期纤维化显著相关(P = 0.01, P = 0.016, P = 0.027, P = 0.016, P = 0.009,对照),与HBeAg-患者的ALB、GLOB、WBC、PLT和PT显著相关(P < 0.001, P = 0.004, P = 0.005, P < 0.001, P = 0.035,对照)。PLT是肝硬化的极好预测因子(P < 0.001, AUROC = 0.805)。ALT不能预测HBeAg+或HBeAg-患者的晚期纤维化(P = 0.273和P = 0.599,分别为P值)。PLT是慢性乙型肝炎患者肝硬化的一个很好的预测指标。对于ALT正常、PLT较低、ALB较低的老年慢性HBV携带者,建议进行肝脏组织病理学检查。
Parameters associated with significant liver histological changes in patients with chronic hepatitis B.
This study aimed to evaluate factors associated with significant liver histological changes. Liver biopsies from 157 CHB patients were retrospectively analyzed. Only ALB was significantly correlated with advanced liver necroinflammatory (P = 0.001). Age, ALB, GLOB, AST, PLT, and PT were independent predictors of significant fibrosis (P = 0.002, P < 0.001, P = 0.001, P = 0.048, P < 0.001, and P = 0.001, resp.). AST, WBC, and HBV DNA were significantly correlated with advanced fibrosis in normal ALT patients (P < 0.001, P = 0.041, and P = 0.012, resp.) and age, ALB, GLOB, PLT, and PT in patients with abnormal ALT (P = 0.003, P < 0.001, P = 0.004, P < 0.001, and P = 0.002, resp.). Age, AST, GGT, PLT, and PT were significantly associated with advanced fibrosis in HBeAg+ patients (P = 0.01, P = 0.016, P = 0.027, P = 0.016, and P = 0.009, resp.) and ALB, GLOB, WBC, PLT, and PT in HBeAg- patients (P < 0.001, P = 0.004, P = 0.005, P < 0.001, and P = 0.035, resp.). PLT was an excellent predictor for cirrhosis (P < 0.001 and AUROC = 0.805). ALT was not predictive of advanced fibrosis for patients with HBeAg+ or HBeAg- (P = 0.273 and P = 0.599, resp.). PLT was an excellent predictor for cirrhosis in CHB patients. Liver histopathology can be recommended for chronic HBV carriers of older age, with normal ALT, lower PLT, and lower ALB.