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相关的因素.方法:回顾分析284例ALT正常的慢性乙型肝炎患者临床资料,对患者年龄、性别、乙肝病毒血清学标志物、血常规、生物化学检查、甲胎蛋白、血清肝纤维化指标、凝血功能和超声影像学检查等29项指标与肝组织病变程度进行相关性分析.结果:年龄、PLT、肝包膜改变及脾大是肝组织学病变程度相关的独立因素.结论:常规地应用某单项无创性诊断指标尚无法准确地反映肝组织病变程度,联合多种无创性诊断指标一定程度上有助于预测肝组织学改变.%Objective To analyze the factors affecting the changes of liver histology in patients with chronic hepatitis B (CHB) and normal alanine aminotransferase (ALT) levels. Methods 284 patients with CHB and normal ALT levels were retrospectively studied. Correlation between liver histology and patient's age, gender, hepatitis B viral markers, blood routine examination, biochemical examination, alpha fetoprotein, serum fibrosis marks, coagulation function and sonographic examination were analyzed statistically. Results Age, platelet counts, changes of liver capsular, and splenomegaly were the independent relative factors that correlated with the changes of liver histology. Conclusion Single non-invasive indicator did not help to predict the changes of liver histology, but combination of multiple non-invasive index would do better.
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