目的 探讨慢性乙型肝炎自然病程中血清AFP水平变化与肝组织炎症分级和肝纤维化分期的关系.方法 在189例慢性乙型肝炎患者行肝活检,并检测血清甲胎蛋白水平.结果 在HBeAg阳性者,肝组织炎症1、2、3和4级血清AFP水平分别为4.09±1.94μg/L、6.51±3.42μg/L、19.71±23.72μg/L和33.88±24.29μg/L;在HBeAg阴性者,分别为3.99±2.65μg/L、6.74±4.22μg/L、22.21±23.83μg/L和40.02±45.32μg/L;在HBeAg阳性者,肝纤维化Ⅰ、Ⅱ、Ⅲ和Ⅳ期血清AFP水平分别为5.28±3.00μg/L、6.97±3.46μg/L、18.16±20.26μg/L和35.06±28.56μg/L;在HBeAg阴性者,肝纤维化Ⅰ、Ⅱ、Ⅲ和Ⅳ期血清AFP水平分别为4.89±3.20μg/L、5.62±3.40μg/L、19.51±23.00μg/L和32.89±37.88μg/L.结论 在慢性乙型肝炎的自然病程中,血清AFP水平的轻度升高与肝组织炎症分级和肝纤维化分期相关,而与HBeAg状态无关.%Objective The aims of this study are to clarify the relationships among the serum alpha-fetal protein(AFP) levels and liver histological activity index and hepatic fibrosis stages, as well as the status of HBeAg in patiemts with chronic hepatitis B. Methods The serum AFP levels were detected in 189 patients with chronic hepatitis B who had liver biopsies. Results The serum AFP levels in patients with hepatic histological inflammation grade 1,2, 3and 4 were 4.09 ±1.94μg/L, 6.51 ±3.42μg/L, 19.71 ±23.72μg/L and 33.88 ±24.29 μg/L in HBeAg positive chronic hepatitis B, and 3.99±2.65μg/L,6.74±4.22μg/L,22.21±23.83μg/L and 40.02±45.32μg/L in HBeAg negative group, respectively; The serum AFP levels in hepatic fibrosis stage Ⅰ, Ⅱ, Ⅲand Ⅳwere 5.28±3.00μg/L, 6.97±3.46μg/L, 18.16±20.26μg/L and 35.06±28.56μg/L in HBeAg positive chronic hepatitis B, and 4.89±3.20μg/L, 5.62±3.40μg/L, 19.51±23.00μg/L and 32.89±37.88μg/L in HBeAg negative group, respectively. Conclusions The mild increases of serum AFP levels are related to liver histological inflammation grades and fibrosis stages but not the status of HBeAg during the natural history of chronic hepatitis B.
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