HBeAg阴性与阳性慢性乙型肝炎患者临床和病毒学特点分析

摘要

目的:回顾性分析HBeAg阴性和HBeAg阳性慢性乙型肝炎(CHB)患者在HBV DNA载量、肝功能及肝脏组织病理学方面的特点.方法:对60例CHB患者的临床资料,包括HBV DNA载量、肝功能及肝组织病理学检查结果进行回顾性分析.结果:60例患者中HBeAg阴性24例,占40.0％ (24/60),平均年龄(48.3±7.7)岁；HBeAg阳性36例,占60.0％ (36/60),平均年龄(27.7±9.1)岁,两者在平均年龄之间比较,差异有显著性意义(t =13.4,P＜O.001).HBeAg阴性与阳性患者的HBV DNA载量分别为(5.87±0.66) log拷贝/ml和(7.37±0.50)log拷贝/ml,两者之间比较,差异有显著性意义(t=13.6,P＜0.001)；ALT分别为(115.95±33.6) U/L和( 172.2±84.20) U/L,两者之间比较,差异有显著性意义(t=4.81,P＜0.001).HBeAg阴性患者的肝组织炎症活动度分级(G)及纤维化分期(S)与HBeAg阳性者之间比较,差异无统计学意义(x2值分别为2.53及1.27,P值分别为0.11及0.25).结论:HBeAg阴性CHB患者的平均年龄高于HBeAg阳性者,HBV DNA载量及ALT值低于HBeAg阳性者,但HBeAg阴性CHB患者的肝脏组织病理学改变与HBeAg阳性者无差异.%Objective: To retrospectively analyze the characteristics of the HBV DNA loads, liver function and liver histo-pathology between HBeAg-positive and HBeAg-negative patients with chronic hepatitis B (CHB) . Methods: The clinical detection dates of 60 CHB patients, who were hospitalized in our department from May 2010 to October 2010, were analyzed retrospectively, including HBY DNA loads, liver function and liver histopathology. Results: Among 60 CHB patients, 24 cases were HBeAg-negative accounting for 40% (24/60), whose average age were (48. 3 ±7.7) yeas old, and 36 cases were HBeAg-positive accounting for 60% (36/60) , whose average age were (27. 7 ±9. 1) yeas old. There was a significant difference in average age between HBeAg-negative and HBeAg-positive patients with CHB (t = 13.4, P <0. 001) . The HBV DNA loads of HBeAg-negative and HBeAg-positive patients with CHB were (5. 87 ±0. 66) log copies/ml and (7. 37 ±0. 50) log copies/ml respectively, between which there was a significant difference (t =13.6, P < 0. 001) . The alanine transaminase (ALT) value of HBeAg-negative and HBeAg-positive patients with CHB were ( 115. 95 ± 33. 6) U/L and (172. 2 ± 84. 20) U/L respectively, between which there was a significant difference (t =4. 81, P <0.001) . There was no statistically significant in inflammation grade (G) and fibrosis stage (S) of liver tissue between HBeAg-negative and HBeAg-positive patients with CHB (the x2 value were 2. 53 and 1. 27 respectively; the P value were 0.11 and 0. 25 respectively) . Conclusion; The average age of HBeAg-negative patients with CHB are higher than HBeAg-positive patients. The levels of ALT and HBV DNA loads in HBeAg-negative patients with CHB are lower than HBeAg-positive patients. However, there is no difference in liver histopathological changes between HBeAg-negative and HBeAg-positive patients with CHB.