ALT是临床上用于反映肝组织损伤最敏感的生化指标之一.通常认为ALT水平正常的HBV感染者处于免疫耐受状态,肝组织病理无或仅有轻度的炎症,则无需抗病毒治疗.然而ALT水平正常的慢性HBV感染者并非始终处于免疫耐受状态,疾病可隐匿进展为慢性乙型肝炎(CHB),甚至肝硬化、肝细胞癌.因此,ALT水平正常的CHB抗病毒治疗一直是临床研究的热点.主要从ALT与CHB肝组织炎症的关系和ALT水平正常的CHB抗病毒治疗时机等方面进行了阐述.%Alanine aminotransferase (ALT) is one of the most sensitive biochemical parameters used to reflect the degree of liver injury.It is generally believed that patients with hepatitis B virus (HBV) infection and a normal ALT level are in the immune tolerance state,and no antiviral therapy is required in patients without liver inflammation or those with mild liver inflammation.However,these patients are not always in the immune tolerance state,and the disease can insidiously progress to chronic hepatitis B (CHB),liver cirrhosis,and even hepatocellular carcinoma.Therefore,antiviral therapy for CHB patients with normal ALT has always been a hot topic of clinical research.This article elaborates on the association between ALT and liver inflammation in CHB patients and the timing of antiviral therapy for CHB patients with normal ALT.
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