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目的 :通过前瞻性的研究以血清学指标无创性的评价肝组织的炎症程度。方法 :对 65例慢性乙型肝炎患者进行肝功能检测 ,包括谷丙转氨酶 (ALT)、谷草转氨酶 (AST)、谷氨酰转肽酶 (GGT )、胆红素、胆汁酸 (TBA)等 ,纤维化4项 ,包括Ⅳ型胶原、Ⅲ型胶原氨基末端肽 (PⅢP)、层连蛋白 (LN)、透明质酸 (HA)及HBVDNA定量测定 ,同时进行外周血T细胞亚群测定。所有病例均行肝穿刺活组织检查 ,并进行组织学炎症分级及纤维化分期。结果 :一些血清学指标与肝组织炎症分级有一定的相关性 ,以ALT、AST、HA相关性最好 ,相关系数分别为 0 5 0 0、0 469、0 466。肝组织炎症越重 ,纤维化程度也相对越重 ,二者相关系数为 0 5 79。HA在G4组明显升高 ,同其余 3组相比有显著性差异。在各炎症分级ALT、AST数值分布较广 ,在各期有较大重叠。炎症较重组 (G3 、G4组 )ALT、AST ,GGT、TBA的异常率及B细胞、CD4+T细胞比例 ,CD4与CD8比值均高于炎症较轻组 (G1、G2 组 ) ,有显著性差异。HBVDNA含量在各组间无显著性差异。结论 :ALT、AST与肝组织炎症分级有较好的相关性 ,但无法划定其具体界值来判断炎症损害的轻重。肝组织炎症越重 ,纤维化程度也越重 ,因而可导致与肝纤维化关系密切的HA水平的明显升高。血中病毒含量高低与肝脏炎症?
OBJECTIVE: To assess the extent of inflammation in liver tissue by serological markers noninvasively through prospective studies. Methods: Sixty-five patients with chronic hepatitis B were tested for liver function, including ALT, AST, GGT, bilirubin, and bile acid (TBA) Fibrosis, including type Ⅳ collagen, type Ⅲ collagen amino terminal peptide (P Ⅲ P), laminin (LN), hyaluronic acid (HA) and HBVDNA quantitative determination of peripheral blood T cell subsets at the same time. All cases underwent liver biopsy and histological grade and fibrosis staging. Results: Some serological markers had some correlation with inflammation grade of liver tissue. The correlation between ALT, AST and HA was the best, the correlation coefficients were 0 0 0 0 0 469 0 466 respectively. Liver tissue inflammation heavier, the degree of fibrosis is also more serious, the correlation coefficient between 0 5 79. HA significantly increased in G4 group, compared with the remaining three groups were significantly different. ALT in each grade of inflammation, AST values are widely distributed in the various stages of a larger overlap. The abnormal rates of ALT, AST, GGT and TBA in severe inflammation group (G3 and G4), the ratio of B and CD4 + T cells and the ratio of CD4 and CD8 were higher than those in the mild inflammation group (G1 and G2) difference. HBVDNA content in each group no significant difference. Conclusion: There is a good correlation between ALT, AST and inflammation grade of liver tissue, but it can not be delineated to determine the severity of inflammatory damage. Liver tissue inflammation more severe, more severe degree of fibrosis, which can lead to liver fibrosis and closely linked to the HA level was significantly higher. Blood levels of virus and liver inflammation?