|本期目录/Table of Contents|

[1]郑瑞丹,张闽峰,孟家榕,等.HBeAg阴性慢性乙型肝炎并非酒精性 脂肪性肝病56例临床及病理特征[J].医学研究与战创伤救治(原医学研究生学报),2009,11(01):10-13.
　ZHENG Rui-dan,ZHANG Min-feng,MENG Jia-rong,et al.Study on clinical and pathological characteristic in HBeAg negative chronic hepatitis B patients with nonalcoholic fatty liver disease[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2009,11(01):10-13.
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HBeAg阴性慢性乙型肝炎并非酒精性 脂肪性肝病56例临床及病理特征()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第11卷
期数:
2009年01期
页码:
10-13
栏目:
出版日期:
2009-01-20

文章信息/Info

Title:
Study on clinical and pathological characteristic in HBeAg negative chronic hepatitis B patients with nonalcoholic fatty liver disease
文章编号:
1672-271X(2009)01-0010-04
作者:
郑瑞丹1; 张闽峰1; 孟家榕1; 徐成润1; 陈碧芬1; 陈 洁1; 陆伦根2
1.解放军第175医院肝病治疗中心，福建漳州 363000；2.上海第二医科大学附属仁济医院消化科、上海市消化疾病研究所，上海 200001
Author(s):
ZHENG Rui-dan1; ZHANG Min-feng1; MENG Jia-rong1; XU Cheng-run1;  CHEN Bi-fen1;  CHEN Jie1;  LU Lun-gen2
1. Research and Therapy Center for Liver Diseases，the 175th Hospital of PLA, Zhangzhou 363000, Fujian, China; 2. Department of Gastroenterology, Renji Hospital, Shanghai Second Medical University, Shanghai 200001, China
关键词:
HBeAg阴性; 慢性乙型肝炎; 非酒精性脂肪肝病; 肝活检
Keywords:
HBeAg negative;  Chronic hepatitis B;  Nonalcoholic fatty liver disease;  Liver biopsy
分类号:
R512.62
DOI:
-
文献标志码:
A
摘要:
目的 研究HBeAg阴性慢性乙型肝炎并非酒精性脂肪性肝病患者的临床病理特征。方法 对临床与病理学确诊的HBeAg阴性慢性乙型肝炎并非酒精性脂肪性肝病患者，检测空腹血糖与胰岛素、甘油三酯、胆固醇、丙氨酸氨基转氨酶、天冬氨酸氨基转氨酶；检测乙肝病毒标志物与HBV DNA，计数体重指数与胰岛素抵抗指数，观察其病理特征。结果 HBeAg阴性慢性乙型肝炎并非酒精性脂肪性肝病患者其体重指数、胰岛素抵抗指数、空腹血糖、空腹血胰岛素、甘油三酯、胆固醇均显著高于HBeAg阴性慢性乙型肝炎患者；而转氨酶水平、HBV DNA载量低于HBeAg阴性慢性乙型肝炎患者；HBeAg阴性慢性乙型肝炎并非酒精性脂肪性肝病患者病理学改变以脂肪变性为主，汇管区及界面性炎较轻，肝细胞脂肪变主要在腺泡Ⅲ带、呈弥漫分布。结论 HBeAg阴性慢性乙型肝炎并非酒精性脂肪性肝病患者，肝细胞脂肪变的发生主要由患者的代谢因素所致，选择性对存在代谢因素的HBeAg阴性慢性乙型肝炎患者行肝活检，有助于早期明确 HBeAg阴性慢性乙型肝炎并非酒精性脂肪性肝病的诊断。
Abstract:
Objective To investigate clinical and pathological characteristic in HBeAg negative chronic hepatitis B (CHB) patients with nonalcoholic fatty liver disease (NAFLD).Methods We measured fasting blood glucose(FBG), insulin, triglyceride, cholesterol, alanine aminotransferase (ALT), aspartate aminotransferase (AST) in HBeAg negative CHB patients with NAFLD. Hepatitis B Virus marker and HBV DNA were detected. The body mass index(BMI) and insulin resistance index were counted. The pathological parameters were analyzed. Results BMI,homeostatic model assessment of insulin resistance(HOMA-IR),FBG, insulin, triglycerides, cholesterol, were significantly higher in HBeAg negative CHB patients with NAFLD than HBeAg negative CHB patients. But ALT, AST, HBV DNA levels were significantly lower in HBeAg negative CHB patients with NAFLD than in HBeAg negative CHB patients. Histologic features in HBeAg negative CHB patients with NAFLD were in zone 3 predominate over macrovesicular steatosis and mild inflammatory infiltrate in portal region. Conclusion The hepatic steatosis changes in HBeAg negative CHB patients with NAFLD are mainly caused by the metabolic factors. It is helpful for early diagnosis in HBeAg negative CHB patients with NAFLD to selectively carry out liver biopsy for the patients with HBeAg negative CHB having metabolic factors.

参考文献/References:

[1]Hadziyannis SJ,Papatheodoridis GV.Hepatitis Be antigen neg- ative chronic hepatitis B: natural history and treatment[J]. Semin Liver Dis, 2006, 26(2): 130-141.
[2]Angulo P. Nonalcoholic fatty liver disease[J]. Rev Gastroen- terol Mex, 2005, 70(3): 52-56.
[3]Bondini S, Younossi ZM. Non-alcoholic fatty liver disease and hepatitis C infection[J]. Minerva Gastroenterol Dietol, 2006, 52(2): 135-143.
[4]中华医学会传染病与寄生虫病学分会、肝病学分会. 病毒性肝炎防治指南[J]. 中华肝脏病杂志, 2000, 8(6):324-329.
[5]Brunt EM, Janney CG, Di Bisceglie AM, et al. Nonalcoholic steatohepatitis: a proposal for grading and staging the histological lesions[J]. Am J Gastroenterol, 1999, 94(9): 2467-2474.
[6]傅祖植. 开展与肥胖症相关课题的研究是新世纪的迫切任务[J]. 中华内分泌代谢杂志, 2000, 16(2):65-66.
[7]McCullough AJ.Update on nonalcoholic fatty liver disease[J]. J Clin Gastroenterol, 2002, 34(3): 255-262.
[8]Keeffe EB,Marcellin P.New and emerging treatment of chron- ic hepatitis B[J]. Clin Gastroenterol Hepatol, 2007, 5(3): 285-294.
[9]Bondini S, Kallman J, Wheeler A, et al. Impact of non-alco- holic fatty liver disease on chronic hepatitis B liver[J]. Int, 2007, 27(5): 607-611.
[10]Ekstedt M, Franzen LE, Mathiesen UL. Long-term follow-up of patients with NAFLD and elevated liver enzymes[J]. Hepatology, 2006, 44(4): 865-873.
[11]Demir K, Akyuz F, Ozdil S. What is the reason of elevated alanine aminotransferase level in HBeAg negative patients with low viremia: NAFLD or chronic hepatitis[J]?Ann Hepatol, 2007, 6(2): 92-96.

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备注/Memo

备注/Memo:
上海市教委科技发展基金(Y0205)；上海市卫生局课题和漳州市科技局基金资助(Z04094)
更新日期/Last Update: 2013-11-20