摘要
目的:评估慢性无症状乙肝病毒携带者(AsC)肝活检组织学变化的诊治价值。方法:采用Menghini型肝穿刺针取73例血清谷丙转氨酶正常AsC患者肝组织制作病理切片,行HE、Masson染色及免疫组化染色,并进行病理分级、分期及Knodell评分。结果:73例AsC肝组织病理均有异常改变,G1S0者65.8%,G1S1者23.3%,G2S1者6.8%,G2S2者4.1%。Knodell评分2分者51例(69.9%),3分者12例(16.4%),≥4分者10例(13.7%)。免疫组化HBsAg检出率86.3%,以浆膜型为主穴57.14%雪;HBcAg检出率72.97%,以核型为主(74.07%)。结论:血清谷丙转氨酶正常的AsC,肝组织均有一定程度的病变损害,肝活检病理检查在判定AsC病情程度和处理方法方面具有重要的价值。
To evaluate the value in the diagnosis and treatment of liver histological changes in liver biopsy tissues taken from chronic asymptomatic carrier with hepatitis B virus. Methods： The liver biopsy was obtained from 73 asymptomatic carriers by using Menghini puncture needle. Hematoxylin-eosin, and HE, Masson＇s colors and immunohistochemistry staining of the liver biopsy tissues were performed. The necroinflammation grade and fibrosis stage of hepatic histological tissues were classed and scored according to Knodell＇s histology activity index （HAl）. Results： All liver biopsy tissues had inflammatory activity to some extent. Among these patients, 65.8% were G1S0, 23.3% were G1S1, 6.8% were G2S1 ,and 4.1% were G2S2, According to Knodell,51 （69.9%）,12 （16.4%） and 10 （13.7%） had a HA1 score with 2, 3 and ≥4 points, respectively. The positive expression rate of HBsAg in hepatocytes was 86.3%, and the majority （57.14 % ） was cytoplasmmembrane HBsAg expression type,While the positive expression rate of HBcAg in hepatocytes was 72.97%, and the majority was nucleus HBcAg expression type （74.07%）. Conclusion： This study suggested that asymptomatic carriers with normal serum alanine aminotransferase（ALT） have necroinflammation and （or） fibrosis to some extent. Liver biopsy examination is more valuable to evaluate the disease severity of asymptomatic carriers with hepatitis B virus and to determine the method of management.
出处
《天津医药》
CAS
北大核心
2005年第9期550-551,i0001,共3页
Tianjin Medical Journal
