摘要:
目的:探索云南省隐匿性乙型肝炎的临床与病理特征.方法:对5000例HBsAg阴性患者进行血清HBV DNA荧光定量筛查,对检测出HBV DNA阳性的26例隐匿性乙型肝炎患者进行临床、组织病理及免疫组化检查分析.结果:26例隐匿性乙型肝炎患者中肝组织病理检查显示慢性肝炎26例,其中炎症活动度轻中度损害24例,重度2例;轻度到中度肝纤维化25例,早期肝硬化1例.瞬时弹力检测FibroScan肝纤维化检查显示:轻度2例,中度17例,重度6例,早期肝硬化1例.26例患者肝穿病理检查肝纤维化程度与FibroScan肝纤维化检查结果吻合度一致.免疫组化检测显示肝组织中HBsAg阳性9例,HBcAg阳性10例.结论:隐匿性乙型肝炎,是导致终末期隐匿性肝脏疾病的主要原因之一,需要及时发现并立即治疗.%Objective:To explore the clinical and pathological features of occult hepatitis B in Yunnan Province. Methods:Serum HBV(Hepatitis B Virus,HBV)DNA levels were tested in 5 000 HBsAg negative patients.Clinical,histopathologic and immunohistologic tests were done in 26 HBV DNA positive, occult hepatitis B patients. Results: Histopathologically, 26 cases were chronic hepatitis, among them,24 had mild to moderate inflammation,2 had severe inflammation.25 had mild to moderate fibrosis,1 had early cirrhosis. There were 2 cases of mild fibrosis, 17 cases of moderate fibrosis, 6 cases of severe fibrosis, 1 case of early cirrhosis according to Fibroscan tests. The Fibroscan results coincided with the pathologic results. Immunohistologically, 9 cases were HBsAg positive, 10 were HBcAg positive. Conclusion: Occult hepatitis B is one of the main cause of end-stage occult liver diseases and needs to be diagnosed and treated immediately.