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目的 :探讨慢性乙型肝炎急性发作时 ,HBV复制水平与肝脏组织损伤程度之间的关系。方法 :对 44例自发性发作的慢性乙型肝炎患者进行肝组织活检 ,并采用荧光定量多聚酶链反应测定血清HBVDNA含量。结果 :血清HBVDNA含量与肝脏炎症程度 (G1～G4)及纤维化程度 (S1～S4)之间比较 ,无明显相关性 (P >0 .0 5 ) ;与血清丙氨酸转氨酶 (ALT)、门冬氨酸转氨酶 (AST)及总胆红素 (T -BILI)之间也无相关性。结论 :肝细胞损伤程度与不同个体中的HBV复制的绝对数值没有关系。提示HBV不直接致肝细胞病变 ,不同个体复杂的免疫反应决定了肝脏的损伤程度。
Objective: To investigate the relationship between the level of HBV replication and the extent of liver tissue damage in the acute episode of chronic hepatitis B. Methods: Liver biopsy was performed in 44 patients with chronic hepatitis B who had spontaneous seizures. The serum HBVDNA content was measured by fluorescence quantitative polymerase chain reaction. Results: There was no significant correlation between serum HBVDNA level and the degree of hepatic inflammation (G1 ~ G4) and fibrosis degree (S1 ~ S4) (P> 0.05), but not with serum ALT, There was also no correlation between aspartate aminotransferase (AST) and total bilirubin (T-BILI). Conclusion: The degree of hepatocellular injury is not related to the absolute value of HBV replication in different individuals. Prompt HBV does not directly lead to hepatocellular lesions, different individuals of the complex immune response determines the degree of liver damage.