ABSTRACT
Objective To explore the relationship between the liver volume atrophy rate,liver stiffness measurements(LSM) and Child-Turcotte-Pugh(CTP) value with the Laennec histopathological classification in the patients with hepatitis B cirrhosis and its value in the quantitative diagnosis of liver cirrhosis degree.Methods The clinicopathological data of liver biopsy tissue pathological slides,FibroScan,CT examination and hematological detection in 32 cases of hepatitis B cirrhosis were retrospectively analyzed.Liver cirrhosis was divided into mild,moderate and severe according to the Laennec liver cirrhosis histopathological classification.Then the relationship between the liver volume atrophy rate,LSM and CTP score with liver cirrhosis histopathological.Results Among 32 cases,9 cases(28.12％) were mild,12 cases(37.50％) were moderate and 11 cases(34.38％) were severe.The liver volume atrophy rates of mild,moderate and severe groups were (16.75±2.20)％,(23.11±6.67)％ and(35.55±5.70)％ respectively;LSM were(14.96±3.36),(20.21± 3.07),(37.03 ± 16.44) kPa respectively,the difference among 3 groups was statistically significant (P＜ 0.01).The CTP scores had no statistical difference among the 3 groups were(P＞0.05).The cirrhosis histopathological grade had the positive correlation with the liver volume atrophy rate and LSM(r=0.93,0.74,P＜0.01),however had no obvious correlation with the CTP scores(r=0.27,P＞0.05);the liver volume atrophy rate was positively correlated with LSM and CTP score(r=0.90,0.91,P＜0.01);while LSM had no obvious correlation with CTP score (r =0.15,P ＞ 0.05).Conclusion The more severe the cirrhosis histoathological grade,the bigger the liver volume atrophy rate and the higher the FibroScan detection value;the liver volume atrophy rate and LSM may serve as the quantitative diagnosis indicators of liver fibrosis histopathological severity.
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Objective To compare the influence of different genotypes of hepatitis B virus to the body's immune function.Methods 377 patients with chronic hepatitis B virus (serum HBV DNA are all positive)were selected.The serum specimens were collected.Nest PCR method was used to detect all entrants subtype HBV genotypes,ELISA method was used to detect serum levels of IL -10 and IL -17,fully automatic biochemical instrument was used to test all entrants liver function.Results Of 377 patients with chronic hepatitis B,C genotype in 323 cases,C2 type in 321 cases (85.1%),C1 type 2 cases (0.5%);Genotype B 41 cases (10.9%),were B2 subtype;B and C mixed 12 cases (3.2%);Type D in 1 case (0.3%).The sex,age,ALT,AST,TBIL of B2,C2 subtypes,BC mixed infection had no statistically significant differences.B2,C2 subtypes,BC mixed infection had no statistically significant difference in serum IL -17 level.And B2,C2 subtype infection had statistically significant difference in IL -10 level (F =0.444,P <0.05).Conclusion Different genotype HBV subtypes may have different effect to the body's immune function.
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Objective To establish the corresponding relationship between syndrome differentiation of TCM and clinical test results in chronic hepatitis B patients,and thus to provide objective evidence for TCM treatment. Methods 196 patients with chronic hepatitis B,according to the Chinese medicine dialectical typing results were divided into five groups(liver kidney yin deficiency syndrome type 35 cases,Shire Zhongzu syndrome type 24 cases, Yang deficiency of spleen and kidney syndrome type 26 cases,damp heat resistance type and blood stasis syndrome type 42 cases,liver stagnation and spleen deficiency syndrome type 69 cases).HBV -DNA,hepatitis B,TBIL,ALT, TTT were detected.Results In the HBV -DNA test,the majority of the five groups were positive,the overall compar-ison,the difference was not statistically significant (P =0.937).But in the second liver five,TBIL,ALT and TTT detection,the detection results were reflected in the corresponding relationship between TCMsyndrome differentiation. Such as in TTT detection,liver kidney yin deficiency syndrome type and liver stagnation and spleen deficiency syn-drome type group of patients,most patients with TTT detection results between 7 and 10,two groups sequentially com-pared with the other three groups,the differences were statistically significant (all P =0.000);damp heat resistance type and blood stasis type in the patients group,TTT detection results were generally less than 6,two groups in turn compared with the other three groups,the differences were statistically significant (all P =0.000);Yang deficiency of spleen and kidney in the patients group,TTT detection results were generally more than 10,and compared with the other four groups,the differences were statistically significant (all P =0.000).Conclusion TCMsyndrome differen-tiation of chronic hepatitis B patients has a certain correlation with the clinical test results.