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目的 分析我国小儿慢性乙型肝炎临床与肝纤维化病理的有关特征。方法 对 6 6例小儿慢性乙型肝炎患者常规进行甲、乙、丙、戊型肝炎病毒血清学检测、肝功能检查及肝穿病理组织检查。结果 年龄、病程、起病方式在无纤维化组 (S0组 )和明显肝纤维化组 (≥S3)间经统计学处理差异无显著性意义 ;脾大在S0组占 2 9% ,≥S3组占 32 33% ;S0组HBeAg阳性率明显高于≥S3组 (分别为 74 2 9%和 2 9 0 3% ) ;肝脏炎症活动度越高纤维化程度越重。结论 小儿慢性乙型肝炎肝纤维化与年龄、病程、起病方式及乙肝病毒复制无关 ,与肝脏炎症活动度成正相关。小儿慢性乙型肝炎患者出现脾大、凝血酶原活动度异常、血清白蛋白下降及γ 球蛋白升高 ,应高度警惕肝纤维化。
Objective To analyze the clinical features and pathological features of liver fibrosis in children with chronic hepatitis B in our country. Methods Sixty six pediatric patients with chronic hepatitis B were routinely tested for serological, hepatic function and liver biopsy of hepatitis A, B and C hepatitis E virus. Results There was no significant difference in the age, course of disease and onset of disease between the group without fibrosis (S0 group) and the group with obvious liver fibrosis (≥S3) Group accounted for 32.33%. The positive rate of HBeAg in S0 group was significantly higher than that in ≥S3 group (74.29% and 29.03% respectively). The higher degree of inflammatory activity in liver was, the more fibrosis was. Conclusion Hepatic fibrosis in children with chronic hepatitis B has no correlation with age, course of disease, onset and hepatitis B virus replication, and is positively correlated with liver inflammation activity. Children with chronic hepatitis B patients with splenomegaly, abnormal prothrombin activity, serum albumin decreased and gamma-globulin increased, should be highly vigilant liver fibrosis.