目的：分析慢性乙型肝炎(chronic hepatitis B，CHB)合并肝细胞脂肪变性的病理学表现，探讨SIRT3与肝组织炎症反应及脂肪变性的关系。方法：回顾性分析78例CHB肝穿刺活检标本的病理学资料，用免疫组织化学法检测SIRT3在肝组织标本上的表达。结果：78例CHB肝细胞脂肪变性的发生率为33.33%，CHB的炎症程度与肝细胞脂肪变性的发生差异无统计学意义(P>0.05)。CHB合并脂肪变以肝细胞轻度脂肪变为主，脂肪变性的病理类型以大泡性脂肪变性多见。SIRT3在非脂肪变性的肝细胞主要定位在细胞质，在脂肪变性的肝细胞定位在脂滴周围的细胞质。本研究发现在非脂肪变性的CHB中，轻度CHB的SIRT3表达要高于中度及重度组，差异有统计学意义(P<0.05)，而中度及重度组SIRT3的表达差异无统计学意义(P>0.05)。在脂肪变性的CHB，SIRT3的表达与脂肪变性程度的差异无统计学意义(P>0.05)。结论：CHB合并肝细胞脂肪变性并不少见，SIRT3在非脂变CHB肝细胞的表达随炎症程度轻度组要高于中度及重度组，而在CHB合并肝细胞脂肪变性组未发现其对脂变程度有何直接联系，但其能很好的勾勒出脂变的大小和形状对我们判断肝细胞脂变的分型有一定的帮助。
Relationship between SIRT3 and hepatocyte steatosis in chronic hepatitis B
Objective: To analyze the clinicopathological features of hepatocyte steatosis in chronic hepatitis B (CHB), and further investigate the relationship between SIRT3 and hepatocyte steatosis in CHB. Methods: Histopathological features of 78 cases of CHB liver biopsy specimens were retrospectively analyzed. And the expression of SIRT3 was detected by immunohistochemistry. Results: The incidence of steatosis in 78 cases of CHB hepatocyte was about 33.33%, and there was no significant difference in the inflammatory activity and the occurrence of hepatic steatosis in CHB (P>0.05). The degree of hepatic steatosis was mainly caused by mild steatosis of hepatocytes, and bullous steatosis was the most common pathological type in CHB with hepatocyte steatosis. SIRT3 was mainly localized in the cytoplasm in cases without hepatocyte steatosis, while it was localized in the cytoplasm around the lipid droplets in cases with hepatocyte steatosis. We found that SIRT3 expression in the mild inflammatory activity group was much higher than that of moderate and severe groups without steatosis, the difference was statistically significant (P<0.05), while there was no significant difference in the expression of moderate and severe groups (P>0.05). No significant difference of SIRT3 expression was found in CHB with different degrees of hepatic steatosis (P>0.05). Conclusion: Hepatocyte steatosis in CHB is very common. SIRT3 is correlated with the inflammation degree in cases of CHB without steatosis. And it may help us to determine the pathological type of steatosis in CHB.