目的：分析丙氨酸氨基转移酶(ALT)正常的慢性乙型肝炎患者肝组织学改变情况，探讨与肝组织学病变有关的因素。方法：回顾性分析笔者所在医院收治的209例ALT正常的慢性乙型肝炎患者的临床资料，针对患者的性别、年龄以及超声表现中实质回声、包膜情况、PV内径、PV流速等相关指标与肝组织病变的程度做相关性分析。结果：G1占22.97%，S1为23.45%，G2占40.67%，S2为23.45%，G3占33.97%，S3为29.67%，G4占2.39%，S4占23.43%；单因素分析得，炎症分级相关因素为年龄、肝包膜改变、门静脉主干内径，纤维化分期相关因素为年龄、肝包膜改变与MPV；多因素分析得炎症分级与纤维化分期的相关因素均为年龄与肝包膜改变。结论：联合使用多种无创性诊断指标比只应用某单项无创性诊断指标更能准确反映肝组织的病变程度以及预测肝组织学改变。%Objective:To analyze the factors affecting the changes of liver histology in patients with chronic hepatitis B(CHB)and normal alanine aminotransferase (ALT) levels.Method:The author’s hospital were retrospectively studied 209 cases of normal ALT in chronic hepatitis b patients with clinical data,for patient’s gender,age and sonographic findings in parenchyma echo,capsule,PV inside diameter,velocity of PV related index correlation with the degree of liver tissue lesions.Result:G1 was 22.97%,S1 was 23.45%,G2 was 40.67%,S2 was 23.45%,G3 was 33.97%,S3 was 29.67%,G4 was 2.39%,S4 was 23.43%.Single factor analysis,the grade of inflammation related factors as age,liver capsule,portal vein diameter,the related factors for staging fibrosis liver capsule change with age,MPV;multivariate analysis of factors related to the grade of inflammation and fibrosis were age and liver capsule change. Conclusion:Combination of multiple non-invasive index is better than single non-invasive indicator in predicting the changes of liver histology.
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