Correlation between liver pathological features and laboratory parameters of 91 patients of chronic hepatitis B with alanine aminortransferase lower than 2× upper limits of normal

doi:10.3877/cma.j.issn.1674-1358.2020.02.010

Abstract

Abstract:

Objective

To analyze the correlation between liver pathological features and laboratory parameters of chronic hepatitis B (CHB) patients with alanine aminortransferase (ALT) < 2× upper limits of normal (ULN).

Methods

Total of 91 patients with CHB of ALT < 2× ULN who underwent liver puncture in the Sencond People’s Hospital of Lanzhou from January 2017 to May 2019 were collected. According to the results of liver penetrating examination, 61 cases with G2 lower were classified as mild inflammation group, and 30 cases with G2 and above were as moderate inflammation group; 69 cases with S2 lower were as no obvious fibrosis group, and 22 cases with S2 or above were as obvious fibrosis group. Two groups of inflammation and fibrosis patients were respectively compared with blood cells (WBC), liver biochemical indicators, international standard ratio (INR), hepatitis B virus marker (HBV M) and HBV DNA through comparative analysis (Wilcoxon W test and χ² test) and correlation analysis (φ correlation analysis).

Results

Levels of ALT, aspartate aminortransferase (AST), globulin (GLO) and hepatitis B virus e antigen (HBeAg) positive rate were significantly different between the patients in mild inflammation group and moderate inflammation group (Z = 2.095, P = 0.036; Z = 3.927, P < 0.001; Z = 2.900, P = 0.004; χ² = 10.972, P = 0.001). The levels of AST, GLO, WBC, platelet (PLT) and HBeAg positive rate were significantly different between the patients in no significant fibrosis group and obvious fibrosis group (Z = 2.933, P = 0.003; Z = 3.064, P = 0.002; Z = 2.544, P = 0.011; Z = 2.231, P = 0.026; χ² = 10.116, P = 0.001). HBV DNA levels were not significantly different among groups of different liver tissue inflammatory activity and fibrosis degree (Z = 1.908, P = 0.056; Z = 1.729, P = 0.084). The levels of ALT and AST were associated with low degree of inflammatory activity in liver tissue (r_φ = 0.211, P = 0.044; r_φ = 0.284, P = 0.007). The levels of AST and WBC were associated with low degrees of liver fibrosis (r_φ = 0.222, P = 0.035; r_φ = 0.289, P = 0.006). The level of GLO was moderately correlated with liver fibrosis (r_φ = 0.457, P < 0.001).

Conclusions

For patients of CHB with ALT < 2× ULN and HBV DNA positive, HBeAg positive patients were more likely to occur liver fibrosis than HBeAg negative cases. The levels of blood WBC, PLT, AST and GLO were correlated with the degree of liver fibrosis, among which, patients with GLO > 30 g/L had higher correlation with liver fibrosis.

Key words: Chronic hepatitis B, Liver pathological features, Laboratory parameters, Correlation

Wenjuan Shi, Yan Zhang, Zhaoxun Wang, Hong Wan. Correlation between liver pathological features and laboratory parameters of 91 patients of chronic hepatitis B with alanine aminortransferase lower than 2× upper limits of normal[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2020, 14(02): 138-143.

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References 24

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界面炎	小叶内炎症坏死	组织学活动度（A）^a
0（无）	0（无或轻度）	0（无）
0	1（中度）	1（轻度）
0	2（重度）	2（中度）
1（轻度）	0，1	1
1	2	2
2（中度）	0，1	2
2	2	3（重度）
3（重度）	0，1，2	3

界面炎	小叶内炎症坏死	组织学活动度（A）^a
0（无）	0（无或轻度）	0（无）
0	1（中度）	1（轻度）
0	2（重度）	2（中度）
1（轻度）	0，1	1
1	2	2
2（中度）	0，1	2
2	2	3（重度）
3（重度）	0，1，2	3

病变	纤维化分期（F）
无纤维化	0
门管区纤维性扩大，但无纤维间隔形成	1
门管区纤维性扩大，少数纤维间隔形成	2
多数纤维间隔形成，但无硬化结节	3
肝硬化	4

病变	纤维化分期（F）
无纤维化	0
门管区纤维性扩大，但无纤维间隔形成	1
门管区纤维性扩大，少数纤维间隔形成	2
多数纤维间隔形成，但无硬化结节	3
肝硬化	4

指标	轻度炎症组（61例）	中度炎症组（30例）	统计量	P值
ALT [M（P25，P75），U/L]	33.0（22.0，49.0）	4.60（4.20，5.27）	Z = 2.095	0.036
AST [M（P25，P75），U/L]	23.0（21.0，31.0）	32.5（25.8，43.0）	Z = 3.927	< 0.001
TBil [M（P25，P75），μmol/L]	13.00（9.30，15.85）	12.80（9.38，15.00）	Z = 0.046	0.963
ALB [M（P25，P75），g/L]	42.80（40.00，44.65）	42.15（39.58，44.23）	Z = 1.068	0.285
GLO [M（P25，P75），g/L]	24.00（21.85，27.30）	27.90（23.90，30.08）	Z = 2.900	0.004
WBC [M（P25，P75），× 10⁹/L]	5.26（4.60，6.32）	4.98（4.23，6.40）	Z = 1.009	0.313
RBC [M（P25，P75），× 10¹²/L]	4.98（4.50，5.30）	4.60（4.20，5.27）	Z = 1.626	0.104
PLT [M（P25，P75），× 10⁹/L]	169.0（149.0，205.0）	168.0（131.0，216.8）	Z = 0.481	0.630
INR [M（P25，P75）]	1.00（0.97，1.07）	1.03（0.96，1.07）	Z = 0.385	0.700
HBV DNA [M（P25，P75），IU/ml]	1.16 × 10⁴（1.1 × 10³，1.03 × 10⁸）	1.06 × 10⁸（3.16 × 10³，2.57 × 10⁸）	Z = 1.908	0.056
HBeAg阳性[例（%）]	29（47.5）	23（76.7）	χ² = 10.972	0.001
HBeAb阳性[例（%）	32（52.5）	7（23.3）	χ² = 10.972	0.001

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