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目的探讨不同年龄阶段慢性乙肝病毒感染者的肝组织病理特点。方法 288例慢性HBV感染者行1 s肝穿刺,标本均送免疫组化双标记及HE染色、Masson染色、网状纤维染色,进一步分析其病理特点。结果不同年龄根据谷丙转氨酶(ALT)水平[≤1正常值上限(ULN)、1~2 ULN、≥2 ULN]有抗病毒治疗指征比例:≤20岁组为18.2%、66.7%、80.0%;21-30岁组为18.8%、22.7%、57.1%;31-40岁组为37.0%、47.1%、84.6%;≥41岁组为44.2%、51.6%、71.4%。结论对于年龄>30岁的慢性乙肝病毒感染者,若ALT大于正常上限也应考虑抗病毒治疗,对于ALT正常但年龄大于30岁、ALT1-2ULN、有肝硬化肝癌家族史、合并肥胖或脂肪肝的慢性乙肝病毒感染者行肝穿刺可有效指导抗病毒治疗时机。
Objective To investigate the pathological features of liver in patients with chronic hepatitis B virus infection in different age groups. Methods One hundred and eighty-eight patients with chronic HBV infection underwent liver biopsy. The specimens were stained with HE staining, Masson staining and reticular fiber staining. The pathological features were further analyzed. Results Age-dependent ALT (≤1 upper limit of normal (ULN), 1 ~ 2 ULN, ≥2 ULN] There were 18.2%, 66.7%, 80.0 %; 21.8 years old group was 18.8%, 22.7%, 57.1%; 31-40 years old group was 37.0%, 47.1%, 84.6%; 44.1%, 51.6%, 71.4%. Conclusions Antiviral therapy should also be considered if ALT is greater than the upper limit of normal in patients with chronic hepatitis B virus infection at age> 30 years. For patients with normal ALT but older than 30 years and ALT1-2ULN, there is a family history of cirrhosis with hepatocellular carcinoma, with obesity or fatty liver Chronic hepatitis B virus infection in patients with liver biopsy can effectively guide the timing of antiviral therapy.