Objective To explore the difference of liver pathological changes in chronic hepatitis B (CHB) with mild alanine aminotrans-ferase ( ALT) - elevation and to provide evidence for solving the vital problems in antiviral therapy in patients with an ALT less than 80 U/L Methods One hundred and twenty CHB patients with mild ALT - elevation including HBeAg - positive and HBeAg - negative were divided into groups according to serum HBV DNA load and then the patients were sub - divided into two groups based on 2 times ULN ALT levels (80 U/L), which are group A with ALT^80 U/L and group B with ALT < 80 U/L. Transepidermal liver biopsy and histopathology examinations are conducted to compare the difference of pathologic grading and staging of hepatic inflammation and fibrosis between the two groups. Results The result shows that there is no significant differences of hepatic inflammation activity and hepatic fibrosis between group A (ALI>80 U/L) and group B (ALT < 80 U/L) with HBeAg - positive or HBeAg - negative for all groups of different HBV DNA groups ( P > 0.05 ). Conclusion In conclusion, the comparison of liver histology changes for both HBeAg - positive and HBeAg - negative CHB patients with different HBV DNA load indicate that no obvious differences of hepatic inflammation activity and hepatic fibrosis between ALT ≥80 U/L group and ALT < 80 U/L group. The present study provides an important evidence for antiviral treatment in chronic hepatitis B patients with an ALT less than 80 U/L.%目的 探讨ALT轻度升高的慢性乙型肝炎(CHB)患者ALT正常值上限二倍上下的肝脏组织学改变有无差异,以解决ALT＜80 U/L的ALT轻度升高的CHB患者抗病毒治疗问题.方法 将HBeAg阳性和阴性的两种ALT轻度升高的CHB患者120例,按不同HBV DNA水平分组,再以ALT正常值上限的二倍(80 U/L)分为ALT≥80 U/L和ALT ＜80 U/L两组进行肝组织学研究.行肝脏穿刺和病理检查,比较不同HBV DNA水平分组(各分为ALT≥80 U/L和＜80U/L两组)的肝组织学改变有无差异.结果 HBeAg阳性和阴性两种ALT轻度升高的CHB患者(ALT＜ 80 U/L与≥80 U/L两组)的不同HBV DNA水平分组的组织学改变情况,两组肝脏的炎症活动度和纤维化分期差异均无统计学意义(P＞0.05).结论 经比较HBeAg阳性或阴性两种ALT轻度升高的CHB患者的不同HBV DNA水平分组的肝组织学改变情况显示,ALT≥80 U/L和＜80 U/L两组CHB患者的肝脏组织学改变差异均无统计学意义,为ALT ＜80U/L的ALT轻度升高的CHB患者,寻求抗病毒治疗的依据进行了有益的探讨.
展开▼
