Clinical Features And Pathological Changes Of Chronic Hepatitis B With Hepatic Steatosis

Objective To analyze the clinical characteristics and pathological features of hepatic steatosis in patients with chronic hepatitis B(CHB),explore whether mutual cooperation,promote the progress of the disease are the two diseases;hope to find some characteristic clinical indicators through research,to provide reference for clinical early clinical evaluation of CHB with liver steatosis in patients with better the discovery.Methods Retrospective analysis of 1036 cases from February 2004 to April 2013 and received a liver biopsy in the treatment of The No.2 hospital of Ningbo of chronic HBV infection,according to the pathology of liver tissue,the patients were divided into CHB group(control group,n=847)and CHB patients with fatty liver group(observation group,n=189).Among them,CHB combined with fatty liver group was divided into mild group(n=156)and moderate and severe group(n=33).The general data,biochemical indicators,virological parameters and liver histology were analyzed.The measurement data of normal distribution were compared by t test,non normal distribution were analyzed using two independent samples of non parametric test(Mann Whitney U),count data compared by chi square(χ2)test,Spearman correlation analysis was used to analyze the correlation between two variables.Results The incidence of hepatic steatosis in male patients with CHB was significantly higher than that in female(χ2=28.298,P<0.001),and the difference was statistically significant.In < 30 years old and 30~44 years of age,the incidence of male was higher than female,the difference was statistically significant(χ2 15.46 and 14.571,P<0.001),but in≥45 years of age,there was no significant difference between male and female(χ2=0.227,P>0.05).In the observation group,the alkaline phosphatase(ALP),glutamyl transpeptidase(GGT),uric acid,blood glucose,total cholesterol,glycerin three fat levels higher than the control group,the difference was statistically significant(P<0.05),and albumin,globulin,alanine aminotransferase(ALT),aspartate transferase(AST)and the level of HBV-DNA have no statistically significant differences(P>0.05),compare the degree of liver inflammation between the two groups,the difference was not statistically significant(P>0.05),the degree of liver fibrosis(S)between the two groups compare the overall difference is not obvious,but the observation group S < 3 level proportion is large,the difference was statistically significant(P<0.05).Different degrees of hepatic steatosis between groups,severe steatosis group ALT,AST,ALP,GGT levels were higher,there was significant difference between two groups(P<0.05),but there was no statistical difference in albumin,globulin,uric acid,blood glucose,total cholesterol,triglyceride and HBV-DNA differences(P>0.05),the difference was not statistically significant the degree of liver inflammation between the two groups(P>0.05),the difference was statistically significant fibrosis(P<0.05).Conclusion CHB combined with hepatic steatosis was associated with sex,age,ALP,GGT,uric acid,blood glucose,total cholesterol and triglyceride three lipid levels,and ALP and GGT were correlated with the severity of hepatic steatosis.HBV has no direct correlation with hepatic steatosis,and the increase of ALT and AST may be caused by fatty liver,so it must be cautious to take the antiviral treatment.Hepatic steatosis had no significant effect on the degree of inflammation in liver tissue,but the change of hepatic steatosis in CHB patients with low fibrosis was needed to be further studied.