Characteristics Of Liver Histological Abnormalities In Chronic HBV Infection And Their Associated Factors

Object To observe the characteristics of liver histological abnormalities in patients with chronic HBV infection, and then explore the correlation between the clinical pathology and serum biochemistry and the intrahepatic inflammatory and fibrosis in patients with chronic HBV infection. To identify the factors influencing histological changes in paitents with chronic HBV infection,which might provide experimental evidence for the evolving of them. Method 154 patients with chronic HBV infection were collected from our hospital between 2011.1 and 2014.10. According to the level of ALT, these cases were divided into group ALT≤1×ULN,group 1× ULN<ALT≤ 2×ULN and group ALT >2×ULN. Liver biopsies were performed B-Mode ultrasound guiding and histological grade(G) and stage(S) were evaluatedof all patients with chronic HBV infection. The serum markers of HBV were detected by enzyme-linked immunosorbent assay test(ELISA).The serum HBV DNA level were detected by real-time fluorescence PCR(PCR-RFLP). The main indicators of liver function wrer detected by automatic biochemical analyzer. At the same time,the expression of hepatitis B surface antigen(HBsAg) and hepatitis B core antigen(HBcAg)was detected by immunal historychemical method in 113 cases. To compare the correlations of clinic and the liver histological abnormalities were analyzed retrospectively.Results 1、Liver pathology inflammation grade was significantly positive correlated with fibrosis stage.The levels of fibrosis increased with aggravation of inflammation..2、There were no significant difference between age of patients and liver pathology inflammation grades and fibrosis stages(P > 0.05). But age was positively correlated with fibrosis stages with normal ALT elevation(P < 0.05).3、 The degrees of liver pathology inflammation grades were positive correlated with the levels of ALT and AST(P<0.05).And was negative correlated with the levels of HBV DNA(P<0.05). The degree of liver pathology fibrosis stages were positive correlated with the levels of ALT,AST and TBil(P < 0.05).And were negitive correlated with the levels of ALB and HBV DNA(P < 0.05, P < 0.01).4、 There were significant difference between degrees of damage in liver inflammation grades and fibrosis stages in different levels of ALT.The degrees of liver inflammation grades and fibrosis stages in groups of who have higher levles of ALT both higher than the group of lower. Significantly difference(P<0.05)in of fibrosis stages was found between 0.5×ULN<ALT≤1×ULN group and ALT ≤0.5×ULN group.5 、 There were significant difference between degrees of damage in liver inflammation grades and fibrosis stages in different levels of HBV DNA.The degree of liver inflammation were both significant difference between The mean ages of patients with midle and low levels of HBV DNA were much older, and their histological grades of liver inflammation and stages of fibrosis were relatively higher.6、The degrees of liver inflammation were no significant difference between HBeAg negative group and HBeAg positive group. The levels of liver fibrosis in HBeAg negative group were significantly more severe than HBeAg positive group.7、For HBsAg, the degrees of liver inflammation and fibrosis was no statistically significance between the group of cytoplasm type and cytoplasm-membranou type. For HBcAg, the degrees of liver inflammation and fibrosis were both more serious in cytoplasm menlbmce type compared with cytoplasm-nucleus type.8、The positive expression rates of HBsAg and HBcAg in liver tissue in patients with chronic HBV infection were 73.45% and 78.76%. There was no statistically significance between positive expression rates of cases had grade 2 or 2+ of liver inflammation and grade 2- of liver inflammation.There was also no statistically significance between positive expression rates of cases had stage 2 or 2+ of liver fibrosis and stage 2-. Conclusions The degrees of liver pathology inflammation grades can be reflacted by age, the levels of serum ALT,AST,TBIL,HBV DNA and the state of HBe Ag in patients with chronic HBV infection. Patients with chronic HBV-infected with normal ALT elevation should be accurately determine the degree of liver damage by combining various clinic and liver histology. There has a high positive expression rates of HBsAg and HBcAg in liver tissue in patients with chronic HBV infection. But the rates can’t reflact the degree of liver damage compeletly.It might play an important regulatory role in the development of liver disease.