【摘 要】
：
目的 分析合并非酒精性脂肪肝(nonalcoholic fatty liver disease,NAFLD)的慢性乙型肝炎(chro-nic hepatitis B,CHB)患者的肝组织病理变化特征.方法 收集2011年1月—2017年12月深圳市第三人民医院确诊的187例肝病患者临床资料.所有患者均接受肝穿刺活检病理检查且诊断了临床分级和分期.其中,41例为NAFLD患者、103例为CHB合并NAFLD患者,43例为CHB患者,对比分析不同组别肝脏组织的病理变化.结果 CHB合并NAFLD患者中,纤维化
【机 构】
：
深圳市第三人民医院感染科,广东深圳 518112;中山大学附属第七医院消化医学中心,广东深圳 518107;深圳市第三人民医院感染科,广东深圳 518112;萍乡市第二人民医院超声科,江西萍乡 337
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目的 分析合并非酒精性脂肪肝(nonalcoholic fatty liver disease,NAFLD)的慢性乙型肝炎(chro-nic hepatitis B,CHB)患者的肝组织病理变化特征.方法 收集2011年1月—2017年12月深圳市第三人民医院确诊的187例肝病患者临床资料.所有患者均接受肝穿刺活检病理检查且诊断了临床分级和分期.其中,41例为NAFLD患者、103例为CHB合并NAFLD患者,43例为CHB患者,对比分析不同组别肝脏组织的病理变化.结果 CHB合并NAFLD患者中,纤维化分期与脂肪变性程度分级间呈负相关(r=-0.241,P=0.014),纤维化分期与炎症程度分级之间呈正相关(r=0.235,P=0.017),脂肪变性程度分级与炎症程度分级间无显著相关性(r=0.027,P=0.788).与NAFLD组患者相比,CHB合并NAFLD组患者的肝脂肪变性分级(x2=14.995,P=0.002)、肝纤维化分期(x2=19.229,P=0.000)差异有统计学意义;与CHB组患者相比,CHB合并NAFLD组患者肝纤维化分期差异有统计学意义(x2=26.602,P=0.000).结论 CHB合并NAFLD患者的肝组织损伤程度不同于单纯的CHB和NAFLD患者,CHB合并NAFLD患者的纤维化程度轻于CHB患者.与CHB相比,CHB合并NAFLD不加重患者肝脏炎症程度.
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