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首页> 中文期刊> 《中华临床感染病杂志》 >慢性乙型肝炎合并肝脂肪变性患者的临床及病理特征分析

慢性乙型肝炎合并肝脂肪变性患者的临床及病理特征分析

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摘要

Objective To analyze the clinical and pathological features of chronic hepatitis B (CHB) patients with hepatic steatosis.Methods Clinical and pathological data of 841 patients with CHB who underwent liver biopsy in Zhejiang Provincial People’s Hospital during September 2015 to September 2018 were retrospectively reviewed.One hundred and thirty five gender and age-matched pairs of steatosis and non-steatosis patients entered the analysis.Multivariable Logistic regression and rank sum test were used to analyze the clinical features and risk factors of hepatic steatosis in CHB patients .Spearman correlation test was used to analyze the correlation between hepatic steatosis and HBV DNA , hepatic inflammation and fibrosis status.Results Logistic regression analysis showed that overweight ／obesity ( χ2 ＝3.947, OR ＝1.436, 95%CI 1.005-2.051, P＜0.05) and hyperlipidemia (χ2 ＝4.277,OR＝1.803,95%CI 1.031-3.151, P＜0.05) were the risk factors for hepatic steatosis in CHB patients.There was no correlation of hepatic steatosis with serum HBeAg and HBV DNA levels (Z＝-1.762,r＝-0.011, both P＞0.05). However, hepatic steatosis was negatively correlated with inflammatory grade and fibrosis grade of the liver (r＝-0.146 and -0.192, both P＜0.05).Conclusions Overweight／obesity and hyperlipidemia are associated with steatosis in CHB patients.Hepatic steatosis may not aggravate the degree of liver inflammation and fibrosis in CHB patients.%目的 分析慢性乙型肝炎(Chronic hepatitis B,CHB)合并肝脂肪变性患者的临床特点,并对其病理特征进行分析.方法 回顾性分析2015年9月至2018年9月在浙江省人民医院行肝穿刺检查的CHB患者共841例,根据肝脏病理组织中脂肪变性程度,分为脂肪变性组和非脂肪变性组,采用倾向值匹配法按照性别相同、年龄相近(≤1岁)的原则进行配对,共获得135对CHB患者,采用秩和检验和多因素 Logistic 回归分析CHB 患者合并肝脂肪变性的临床特征及其危险因素,采用Spearman秩相关分析肝脂肪变性的程度与HBV DNA水平和肝脏炎症及纤维化的关系.结果 多因素Logistic回归分析显示,超重／肥胖(χ2 ＝3.947,OR＝1.436,95%CI 1.005～2.051,P＜0.05)及高脂血症(χ2 ＝4.277,OR＝1.803,95%CI 1.031～3.151,P＜0.05)为CHB患者发生肝脂肪变性的危险因素.肝脂肪变性程度与血清HBeAg、HBV DNA均无相关性(Z＝-1.762,r＝-0.011,P＞0.05),但与肝脏炎症活动度分级及纤维化程度分期呈负相关(r＝-0.146和-0.192,P＜0.05).结论 超重／肥胖及高脂血症的CHB患者容易发生脂肪变性,肝脂肪变性并不会加重CHB患者肝脏炎症及纤维化程度.

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  • 来源
    《中华临床感染病杂志》 |2019年第2期|87-92|共6页
  • 作者

    Zheng Wei; Pan Hongyi; Wu Qingqing; Yin Qiaoqiao; Dai Yining; Pan Hongying;

  • 作者单位

    Department of Infectious Diseases, Zhejiang Provincial People’s Hospital, Hangzhou 310014, China;

    Department of Internal Medicine, Pujiang People’s Hospital of Zhejiang Province, Jinhua 322200,China;

    The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, China;

    Facutty of Graduates Bengbu Medical College of Anhui Province, Bengbu 233030,China;

    Department of Infectious Diseases, Zhejiang Provincial People’s Hospital, Hangzhou 310014, China;

    Department of Infectious Diseases, Zhejiang Provincial People’s Hospital, Hangzhou 310014, China;

  • 原文格式 PDF
  • 正文语种 chi
  • 中图分类
  • 关键词

    乙型肝炎,慢性; 肝脂肪变性; 肝脏炎症; 纤维化; 倾向值匹配法;

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