目的 探讨体格检查慢性肝病体征对评估乙型肝炎病毒(HBV)慢性感染者肝病理程度的价值.方法 回顾362例肝活检的HBV慢性感染者慢性肝病体征阳性、阴性以及阳性者单项、多项存在情况,比较各组的肝组织炎症分级(G)及纤维化分期(S),计算慢性肝病体征阳性与阴性判断肝组织炎症分级和纤维化分期的曲线下面积.结果 体征阳性组和阴性组各181例,2组在各肝组织G及S分布比较均有显著性差异(P均＜0.01);多项体征阳性147例,单项体征阳性34例,多项体征阳性组与单项体征阳性组在各G及S分布比较无显著性差异(P均＞0.05);体征阳性组≥G2者178例占98.34%,≥S2者174例占96.13%;体征阴性组≤G2者142例占78.45%,≤S2者167例占99.27%;慢性肝病体征阳性与阴性判断肝组织炎症分级和纤维化分期的曲线下面积分别为0.868和0.919.结论 慢性肝病体征的阳性与阴性对判断肝组织炎症分级和纤维化分期的敏感度较高.%Objective It is to approach the value of chronic liver disease signs in estimating liver pathology of patients with hepatitis B virus. Methods In retrospected the situations of positive andnegative chronic liver disease signs, positive clinical implication and positive anti-reproductive of 362 patients with HBV chronic liver disease. The areas under curve of liver tissue inflammation grades ( G ) and fibrosis staging ( S ) were calculated, which were judged by the sign of chronic liver disease positive and the negative's. Results The positive group and negative group both had 181 cases, and there were significant difference in distribution of G and S of liver tissue between the both groups ( all P < 0. 01 ). 34 cases positive clinical implication and 147 cases positive anti - reproductive, There was no significant difference in distribution of G and S between them ( P > 0. 05 ). In group of signs positive, the staging of 178 cases( 98. 34% )≥G2 , 174 cases ( 96. 13% ) ≥S2 ; In group of signs negative ,142 cases ( 78. 45%' )≤G2 , 167 cases ( 99. 27% ) ≤S2. The areas under curve of judged liver tissue G and S by the signs of chronic liver disease positive and negative was 0. 868 and 0. 919 respectively. Conclusion To estimate liver tissue inflammation grades and fibrosis staging by the signs of chronic liver disease positive and negative is more sensitive.
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