慢性乙型肝炎合并肝脂肪变的临床病理学特点及相关因素分析

摘要

Objective To study the clinic-pathological characteristics and related factors in the patients of chronic hepatitis B with hepatic steatosis. Methods A total of 306 cases of chronic hepatitis B were chosen for this study, and divided into two groups according to the percentage of hepatic steatosis less than 5％ or more than 5％. The two groups were compared regarding the presence of risk factors for steatosis and clinical laboratory, virological and histological characteristics. Results Among 306 chronic hepatitis B patients, there were 141 cases with steatosis (46.1％) and 165 cases without steatosis (53.9％), respectively. High body mass index (BMI) and sex were independent factors and significantly higher in steatosis group than that in the group without steatosis (P＜0.0001 and P-0.008, respectively). No significant difference were found in the other parameters between two groups, including age, blood sugar, cholesterol, viral load, histological activity (HAI) and stage (P＞0.05). Conclusion The risk factors mainly related to steatosis were high body mass index and sex in chronic hepatitis B with steatosis.%目的 探讨慢性乙型肝炎(CHB)合并脂肪肝的临床病理学特征及相关因素.方法 病例选自2008年7月～2009年12月期间有肝活组织检查的CHB患者306例,根据肝组织中脂肪变肝细胞＜5%小叶内肝细胞者为CHB组,脂肪变肝细胞＞5%者,为CHB合并脂肪肝组.对两组的临床与病理特征进行比较.结果 306例CHB患者中,合并肝脂肪变141例(46.1%),不合并肝脂肪变165例(53.9%).各种临床生化及病理指标中,高体重指数(P＜0.0001)和性别(P=0.008)是CHB患者合并肝细胞脂肪变的危险因素,与患者年龄、血糖、胆固醇和肝组织学炎症分级和分期无关(P＞0.05).结论 CHB合并肝脂肪变的发生主要与高体重指数及男性相关.