肺结核对慢性乙型肝炎患者肝组织的影响

Effect of pulmonary tuberculosis on liver tissue in patients with chronic hepatitis B

摘要:

目的 分析肺结核对慢性乙型肝炎患者肝组织的影响。方法 选取2013 年6 月-2016 年6 月 于贵州省六盘水市人民医院收治的576 例慢性乙型肝炎合并肺结核的患者作为观察组，并选取同期该院收 治的576 例慢性乙型肝炎患者作为对照组。比较两组患者的肝功能各项指标、肝组织病理结果及肝组织学 Ishak 积分。结果 两组患者的天冬氨酸转氨酶、丙氨酸转氨酶、总胆红素、凝血酶原时间及白细胞分化抗 原CD57+T 淋巴细胞水平比较无差异（P >0.05）；两组患者白蛋白、胆碱酯酶、CD20+T 淋巴细胞、CD8+T 淋巴细胞及CD4+T 淋巴细胞水平比较有差异（P <0.05），两组患者肝组织炎症活动分级比较有差异（P <0.05）； 两组患者的纤维化分期比较无差异（P >0.05）。观察组碎片状坏死、汇管区炎性改变Ishak 积分及总分均高于 对照组（P <0.05）。结论 肺结核会对慢性乙型肝炎患者的肝组织造成损伤，临床中应密切观察患者肝功能 各项指标，及时给予针对性治疗，改善患者预后。

Abstract:

Objective To analyze the effect of tuberculosis on liver tissue of the patients with chronic hepatitis B. Methods In this study, 576 cases of chronic hepatitis B complicated with pulmonary tuberculosis treated in our hospital from June 2013 to June 2016 were enrolled into the observation group, and 576 cases of chronic hepatitis B patients in our hospital were selected into the control group. Liver function indexes, pathological changes of the liver tissue, and Ishak scores of liver histology were compared between the two groups. Results There was no significant difference in the level of aspartate aminotransferase, alanine aminotransferase, total bilirubin, prothrombin time or CD57+ T lymphocytes between the two groups (P > 0.05) The The levels of albumin, cholinesterase, CD20+ T lymphocytes, CD8+ T lymphocytes and CD4+ T lymphocytes were significantly different between the two groups (P < 0.05). There was a significant difference in inflammatory activity grade of liver tissue between the two groups (P < 0.05). There was no significant difference in fibrosis staging between the two groups (P > 0.05). The Ishak scores and total scores of debris necrosis and the portal area inflammation in the observation group were higher than those in the control group (P < 0.05). Conclusions Tuberculosis can cause damage to the liver tissue of the patients with chronic hepatitis B. The indicators of liver function should be closely observed in clinic, and targeted treatment should be given in time to improve the prognosis of the patients.