大理大学学报

• 临床医学 • 上一篇    

隐匿性乙型肝炎临床诊断与病理特征分析

  

  1. (1. 大理大学第六附属医院肝病科,昆明650041;2.昆明医科大学公共卫生学院,昆明650500)
  • 收稿日期:2017-08-25 出版日期:2018-02-15 发布日期:2018-02-15
  • 作者简介:杨永锐,主任医师,主要从事慢性肝炎的临床治疗研究.
  • 基金资助:
    昆明市科技局重点项目基金资助(2016-1-S-02885)

Clinical Diagnosis and Pathological Characteristics of Occult Hepatitis B

  • Received:2017-08-25 Online:2018-02-15 Published:2018-02-15

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5 000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。

关键词: 隐匿性乙型肝炎, HBV DNA, 荧光定量PCR, 组织病理检查, 免疫组化

Abstract: 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.

Key words: occult hepatitis B, HBV DNA, qPCR, histopathology examination, immunochemistry