目的探讨不同年龄和血清病毒载量慢性乙型肝炎(CHB)患者肝组织病理学变化的特点。方法2012年9月~2016年9月我院诊治的CHB患者143例,常规进行肝穿刺检查和血清HBV DNA检测。结果肝组织炎症分级为G0期14例(9.8%),G1期79例(55.2%),G2期29例...目的探讨不同年龄和血清病毒载量慢性乙型肝炎(CHB)患者肝组织病理学变化的特点。方法2012年9月~2016年9月我院诊治的CHB患者143例,常规进行肝穿刺检查和血清HBV DNA检测。结果肝组织炎症分级为G0期14例(9.8%),G1期79例(55.2%),G2期29例(20.3%),G3期21例(14.7%),纤维化分期为S0期15例(10.5%),S1期72例(50.3%),S2期30例(21.0%),S3期25例(17.5%),S4期1例(0.1%);年龄较大CHB患者肝纤维化程度较明显(P<0.05),血清HBV DNA水平<5 lg copies/ml组与血清HBV DNA水平≥5 lg copies/ml组肝组织炎症活动度和肝纤维化程度构成比均有统计学差异(P<0.01),后者肝组织具有更为严重的炎症分级或纤维化分期。结论不同年龄和血清病毒载量CHB患者肝组织病理学表现存在一定的差异,了解这些差异并给予适当的处理对于诊治是有积极意义的。展开更多
AIM： To investigate the correlation between hepatitis B virus surface antigen （HBsAg）, hepatitis C virus （HCV） expression in hepatocellular carcinoma （HCC）, the HAI score of the noncancerous region of the liver...AIM： To investigate the correlation between hepatitis B virus surface antigen （HBsAg）, hepatitis C virus （HCV） expression in hepatocellular carcinoma （HCC）, the HAI score of the noncancerous region of the liver and the serum Alpha fetoprotein （AFP） level. METHODS： The patterns of HBsAg and HCV in 100 cases of HCC and their surrounding liver tissues were studied on paraffin-embedded sections with immunohistochemistry, the histological status was determined by one pathologist and one surgeon simultaneously using the hepatitis activity index （HAIl score, and AFP was detected by radioimmunity. The study included 100 consecutive patients who underwent curative resection for HCC. Based on HBsAg and HCV expression, the patients were classified into 4 groups： patients positive for HBsAg （HBsAg group）, patients positive for HCV （HCV group）, patients negative for both HCV and HBsAg （NBNC group） and patients positive for both HBsAg and HCV （BC group）. RESULTS： The BC group had significantly higher HAI scores than the other three groups. （BC 〉 HCV 〉 HBsAg 〉 NBNC）. HBV and HCV virus infection was positively correlated with HAI （rs = 0.39, P = 0.00011. The positive rate of AFP （85.7%） and the value of AFP （541.2 ng/mL） in the group with HBV and HCV co-infection were the highest among the four groups. The positive rate （53.3%） of AFP and the value of AFP （ 53.3 ng/mL） in the group with none-infection of HBV and HCV were the lowest. HBV and HCV virus infection was positively correlated with AFP（rs = 0.38, P = 0.0001）. CONCLUSION： The AFP increase in patients with liver cancer was positively correlated with the infection of HBV and HCV. The-serum AFP elevation by the infection of HBV and HCV is one of mechanisms which lead to hepatocarcinogenesis, and the antivirus intervening treatment of hepatitis is significant for the prognosis of liver cancer. From our Spearman＇s rank correlation analysis, we can conclude that the severity of virally induced inflam展开更多
目的：研究HBV感染患者外周血TNF-α及T细胞亚群与肝组织活动性指数（ HAI ）的关系。方法237例乙型肝炎患者及12例正常对照肝组织行肝组织病理学检查，按Knodel方法计算HAI积分，并依据肝组织病变程度分为对照组（n＝12）、慢性乙肝轻...目的：研究HBV感染患者外周血TNF-α及T细胞亚群与肝组织活动性指数（ HAI ）的关系。方法237例乙型肝炎患者及12例正常对照肝组织行肝组织病理学检查，按Knodel方法计算HAI积分，并依据肝组织病变程度分为对照组（n＝12）、慢性乙肝轻度组（n＝67）、中度组（n＝89）、重度组（n＝81）。采用酶联免疫吸附法（ ELISA）定量检测血清TNF-α含量。用流式细胞术检测外周血T细胞亚群。结果慢性乙肝轻度、中度、重度组血清TNF-a水平[（29．65±10．15）μg/L、（38．96±7．32）μg/L、（47．73±6．99）μg/L]均明显高于对照组[（13．78±6．40）μg/L]（q＝14．38、19．97、24．83，均P＜0．05），TNF-a水平与慢性乙肝患者肝组织活动性指数呈正相关（r ＝0．708，P ＜0．05）。慢性乙肝中度、重度组患者外周血 CD8＋T 细胞的水平[（27.66±6．63）μg/L、（28．98±5．92）μg/L]均明显高于对照组[（22．32±1．84）μg/L）]（q＝3．84、4．76，均P＜0．05），CD4＋/CD8＋T细胞的比值[（1．32±0．37）、（1．19±0．30））明显低于对照组（1．67±0．14）（q＝4．20、5．72，均P＜0．05），不同级别组织病变活性积分组之间差异无统计学意义（P＞0．05）。结论肿瘤坏死因子α及细胞免疫在乙型肝炎的发生及发展过程中可能起着重要的作用。展开更多
AIM： TO assess the safety and efficacy of antioxidant therapy for patients with chronic hepatitis C virus （HCV） infection.METHODS： One hundred chronic HCV infection patients failed in interferon treatment were enr...AIM： TO assess the safety and efficacy of antioxidant therapy for patients with chronic hepatitis C virus （HCV） infection.METHODS： One hundred chronic HCV infection patients failed in interferon treatment were enrolled and randomly assigned to receive combined intravenous and oral antioxidants or placebo, or oral treatment alone, Primary end points were liver enzymes, HCV-RNA levels and histology.RESULTS： Combined oral and intravenous antioxidant therapy was associated with a significant decline in ALT levels in 52% of patients who received antioxidant therapy vs 20% of patients who received placebo （P = 0.05）. Histology activity index （HAI） score at the end of treatment was reduced in 48% of patients who received antioxidant therapy vs 26% of patients who received placebo （P = 0.21）. HCV-RNA levels decreased by l-log or more in 28% of patients who received antioxidant therapy vs 12% who received placebo （P = NS）. In part 11 of the trial, oral administration of antioxidants was not associated with significant alterations in any of the end points.CONCLUSION： Antioxidant therapy has a mild beneficial effect on the inflammatory response of chronic HCV infection patients who are non-responders to interferon. Combined antiviral and antioxidant therapy may be beneficial for these patients.展开更多
AIM: To evaluate the clinical outcomes of 240-wk treatment with entecavir(0.5 mg) in Chinese nucleosidenaive patients with cirrhosis.METHODS: A total of 204 nucleoside-naive patients with compensated(n = 96) or decomp...AIM: To evaluate the clinical outcomes of 240-wk treatment with entecavir(0.5 mg) in Chinese nucleosidenaive patients with cirrhosis.METHODS: A total of 204 nucleoside-naive patients with compensated(n = 96) or decompensated(n = 108) hepatitis B virus(HBV)-induced cirrhosis at the Department of Gastroenterology of the China-Japan Union Hospital(Jilin University, Changchun, China) who were treated with entecavir(0.5 mg) for 240 wk were enrolled in this study. Liver biopsy samples obtained from 38 patients prior to treatment(baseline) and at week 240 were evaluated by different independent histopathologists. Efficacy assessments included the proportions of patients who achieved an HBV DNA level < 500 copies/m L, the association of interleukin-28 B genetic variation with antivirus therapy, clinical outcomes, and histologic improvement. Changes in liver disease severity were analyzed, and liver histologic evaluation was performed in 38 patients with paired biopsies. Student t tests were used to compare the means of continuous variables between the groups, and the proportions of patients who achieved the endpoints were compared using the χ2 test.RESULTS: At week 240, 87.5% of the patients with compensated cirrhosis and 92.6% of the patients with decompensated cirrhosis achieved a HBV DNA level < 500 copies/m L. Three patients had genotypic entecavir resistance within the 240-wk period. No significant association was observed between virologic response and interleukin-28 genotype(CT, 88.2% vs CC, 90.6%). The proportion of patients with Child-Pughclass A disease was significantly increased at week 240(68%) from the baseline(47%; P < 0.01). The proportion of patients with Child-Pugh class B disease was significantly decreased at week 240(25%) from the baseline(39%; P = 0.02). In the patients with paired liver biopsies, the mean reduction in the Knodell necroinflammatory score from the baseline was 3.58 ± 1.03 points(7.11 ± 1.80 vs 3.53 ± 1.35, P < 0.01). The mean reduction in Ishak fibrosis score from the baseline wa展开更多
文摘目的探讨不同年龄和血清病毒载量慢性乙型肝炎(CHB)患者肝组织病理学变化的特点。方法2012年9月~2016年9月我院诊治的CHB患者143例,常规进行肝穿刺检查和血清HBV DNA检测。结果肝组织炎症分级为G0期14例(9.8%),G1期79例(55.2%),G2期29例(20.3%),G3期21例(14.7%),纤维化分期为S0期15例(10.5%),S1期72例(50.3%),S2期30例(21.0%),S3期25例(17.5%),S4期1例(0.1%);年龄较大CHB患者肝纤维化程度较明显(P<0.05),血清HBV DNA水平<5 lg copies/ml组与血清HBV DNA水平≥5 lg copies/ml组肝组织炎症活动度和肝纤维化程度构成比均有统计学差异(P<0.01),后者肝组织具有更为严重的炎症分级或纤维化分期。结论不同年龄和血清病毒载量CHB患者肝组织病理学表现存在一定的差异,了解这些差异并给予适当的处理对于诊治是有积极意义的。
文摘AIM： To investigate the correlation between hepatitis B virus surface antigen （HBsAg）, hepatitis C virus （HCV） expression in hepatocellular carcinoma （HCC）, the HAI score of the noncancerous region of the liver and the serum Alpha fetoprotein （AFP） level. METHODS： The patterns of HBsAg and HCV in 100 cases of HCC and their surrounding liver tissues were studied on paraffin-embedded sections with immunohistochemistry, the histological status was determined by one pathologist and one surgeon simultaneously using the hepatitis activity index （HAIl score, and AFP was detected by radioimmunity. The study included 100 consecutive patients who underwent curative resection for HCC. Based on HBsAg and HCV expression, the patients were classified into 4 groups： patients positive for HBsAg （HBsAg group）, patients positive for HCV （HCV group）, patients negative for both HCV and HBsAg （NBNC group） and patients positive for both HBsAg and HCV （BC group）. RESULTS： The BC group had significantly higher HAI scores than the other three groups. （BC 〉 HCV 〉 HBsAg 〉 NBNC）. HBV and HCV virus infection was positively correlated with HAI （rs = 0.39, P = 0.00011. The positive rate of AFP （85.7%） and the value of AFP （541.2 ng/mL） in the group with HBV and HCV co-infection were the highest among the four groups. The positive rate （53.3%） of AFP and the value of AFP （ 53.3 ng/mL） in the group with none-infection of HBV and HCV were the lowest. HBV and HCV virus infection was positively correlated with AFP（rs = 0.38, P = 0.0001）. CONCLUSION： The AFP increase in patients with liver cancer was positively correlated with the infection of HBV and HCV. The-serum AFP elevation by the infection of HBV and HCV is one of mechanisms which lead to hepatocarcinogenesis, and the antivirus intervening treatment of hepatitis is significant for the prognosis of liver cancer. From our Spearman＇s rank correlation analysis, we can conclude that the severity of virally induced inflam
文摘AIM： TO assess the safety and efficacy of antioxidant therapy for patients with chronic hepatitis C virus （HCV） infection.METHODS： One hundred chronic HCV infection patients failed in interferon treatment were enrolled and randomly assigned to receive combined intravenous and oral antioxidants or placebo, or oral treatment alone, Primary end points were liver enzymes, HCV-RNA levels and histology.RESULTS： Combined oral and intravenous antioxidant therapy was associated with a significant decline in ALT levels in 52% of patients who received antioxidant therapy vs 20% of patients who received placebo （P = 0.05）. Histology activity index （HAI） score at the end of treatment was reduced in 48% of patients who received antioxidant therapy vs 26% of patients who received placebo （P = 0.21）. HCV-RNA levels decreased by l-log or more in 28% of patients who received antioxidant therapy vs 12% who received placebo （P = NS）. In part 11 of the trial, oral administration of antioxidants was not associated with significant alterations in any of the end points.CONCLUSION： Antioxidant therapy has a mild beneficial effect on the inflammatory response of chronic HCV infection patients who are non-responders to interferon. Combined antiviral and antioxidant therapy may be beneficial for these patients.
基金Supported by Grant from the Youth scientific research fund,No.2013207059
文摘AIM: To evaluate the clinical outcomes of 240-wk treatment with entecavir(0.5 mg) in Chinese nucleosidenaive patients with cirrhosis.METHODS: A total of 204 nucleoside-naive patients with compensated(n = 96) or decompensated(n = 108) hepatitis B virus(HBV)-induced cirrhosis at the Department of Gastroenterology of the China-Japan Union Hospital(Jilin University, Changchun, China) who were treated with entecavir(0.5 mg) for 240 wk were enrolled in this study. Liver biopsy samples obtained from 38 patients prior to treatment(baseline) and at week 240 were evaluated by different independent histopathologists. Efficacy assessments included the proportions of patients who achieved an HBV DNA level < 500 copies/m L, the association of interleukin-28 B genetic variation with antivirus therapy, clinical outcomes, and histologic improvement. Changes in liver disease severity were analyzed, and liver histologic evaluation was performed in 38 patients with paired biopsies. Student t tests were used to compare the means of continuous variables between the groups, and the proportions of patients who achieved the endpoints were compared using the χ2 test.RESULTS: At week 240, 87.5% of the patients with compensated cirrhosis and 92.6% of the patients with decompensated cirrhosis achieved a HBV DNA level < 500 copies/m L. Three patients had genotypic entecavir resistance within the 240-wk period. No significant association was observed between virologic response and interleukin-28 genotype(CT, 88.2% vs CC, 90.6%). The proportion of patients with Child-Pughclass A disease was significantly increased at week 240(68%) from the baseline(47%; P < 0.01). The proportion of patients with Child-Pugh class B disease was significantly decreased at week 240(25%) from the baseline(39%; P = 0.02). In the patients with paired liver biopsies, the mean reduction in the Knodell necroinflammatory score from the baseline was 3.58 ± 1.03 points(7.11 ± 1.80 vs 3.53 ± 1.35, P < 0.01). The mean reduction in Ishak fibrosis score from the baseline wa
