摘要
目的:探索慢性乙型肝炎患者血清病毒学、肝纤维化分级对慢性乙型肝炎合并肝脂肪变性的预测效能及相关性。方法:选择2021年6月至2023年6月150例行肝穿刺活组织检查的慢性乙型肝炎患者作为观察对象,根据肝脏病理中脂肪变性是否≥5%,分为脂肪变性组(脂肪变性≥5%,n=54)和非脂肪变性组(脂肪变性<5%,n=96),回顾性分析两组患者各项临床指标,研究肝脂肪变性与AST、ALT、HBeAg、HBsAg、HBV DNA、肝纤维化分级相关性;进一步分析影响慢性乙型肝炎患者肝脂肪变性的独立因素。结果:两组患者AST、ALT、HBeAg、HBsAg、HBV DNA、肝纤维化分级差异具有统计学意义(P<0.05)。二元Logistic回归分析结果显示,HBeAg、HBsAg、HBV DNA、肝纤维化分级是导致患者肝脂肪变性的危险因素,AST、ALT属于保护因子。Spearman法分析结果显示,肝脂肪变性与AST、ALT呈负相关,与HBeAg、HBsAg、HBV DNA、肝纤维化分级呈正相关(P<0.05)。经ROC曲线分析,AST、ALT、HBeAg、HBsAg、HBV DNA、肝纤维化分级预测肝脂肪变性的AUC分别为0.928、0.802、0.925、0.903、0.917、0.813。结论:慢性乙型肝炎患者HBeAg、HBsAg、HBV DNA水平及肝纤维化分级与肝脂肪变性存在一定关联,且通过重点监测血清病毒学指标以及肝纤维化分级,能够更好预测患者肝脂肪变性情况。
Objective:To explore the prediction efficacy and correlation of serum virology,hepatic fibrosis grade and hepatic steatosis in patients with chronic hepatitis B.Methods:150 patients with chronic hepatitis B who underwent liver biopsy from June 2021 to June 2023 were selected as observation objects.According to whether there was steatosis in liver pathology,they were divided into steatosis group(degeneration ratio ≥5%,n=54) and non steatosis group(degeneration ratio<5%,n=96).The clinical indicators of two groups were retrospectively analyzed to study the correlation between the degree of liver steatosis and AST,ALT,HBeAg,HBsAg,HBV DNA,liver fibrosis grading,and further analysis of independent factors affecting fatty liver degeneration in patients with chronic hepatitis B.Results:There was a statistically significant difference(P<0.05) in AST,ALT,HBeAg,HBsAg,HBV DNA and liver fibrosis grading between the two groups.The results of binary logistic regression analysis showed that HBeAg,HBsAg,HBV DNA and liver fibrosis grading were risk factors for liver steatosis in patients,while AST and ALT were protective factors.The Spearman method analysis results showed that the degree of hepatic steatosis was negatively correlated with AST and ALT,and positively correlated with HBeAg,HBsAg,HBV DNA and liver fibrosis grading(P<0.05).According to ROC curve analysis,the AUCs for predicting the degree of hepatic steatosis by AST,ALT,HBeAg,HBsAg,HBV DNA,and liver fibrosis grading were 0.928,0.802,0.925,0.903,0.917 and 0.813,respectively.Conclusion:There is a certain correlation between the levels of HBeAg,HBsAg,HBV DNA,and the degree of liver fibrosis in patients with chronic hepatitis B and the presence of hepatic steatosis.Moreover,by closely monitoring key serological virological indicators and liver fibrosis grading,it is possible to better predict the extent of hepatic steatosis in patients.
作者
欧双余
唐宝佳
李微微
钟文
OU Shuang-yu;TANG Bao-jia;LI Wei-wei;ZHONG Wen(Department of Clinical Laboratory,Ningde Municipal Hospital of Ningde Normal University,Ningde Fujian,352100,China)
出处
《中西医结合肝病杂志》
CAS
2024年第10期899-902,共4页
Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases
