ALT正常或轻度升高的HBeAg阳性和阴性慢性乙型肝炎肝组织学变化的再关注

摘要

Alanine aminotransferase (ALT)abnormality is an indicator of the degree of liver inflammation caused by immune activation in patients with chronic hepatitis B (CHB).However,approximately half of the CHB patients with normal or mildly elevated ALT levels have concealed significant changes in hepatic histology.CHB patients with normal or mildly elevated ALT levels may have significant histopatho-logical changes in hepatic tissues,and those changes vary between HBeAg(+)and HBeAg(-)CHB patients.Attention and investigation on the clinical management of CHB patients with normal or mildly elevated ALT levels may have great significance in grasping the right treat-ment opportunity and reducing the risk of liver cirrhosis.%ALT异常是慢性乙型肝炎（CHB）患者免疫激活致肝脏炎症活动程度的反映，但约一半的ALT正常或轻度异常的CHB患者却存在肝组织学隐匿进展的显著变化。ALT正常或轻度升高的CHB患者其肝组织病理学可能存在显著变化，且HBeAg阳性和阴性的CHB患者肝组织病理变化存在差异。关注与探讨ALT正常或轻度升高CHB患者的临床管理，对于把握治疗时机及降低肝硬化风险可能具有重要意义。