Objective To observe the clinical characteristics and immune states of HBeAg positive and HBeAg negative patients with chronic hepatitis B (CHB). Methods Total of 234 patients were entolled. The sex, age, disease severity and the level of ALT, HBV DNA load, immunoglobulin (Ig), complement (C), t-lymphocyte subsets of the two groups were compared, respectively. Results The average age of HBeAg negative patients was older (F = 33.075, P = 0.000), the total bilirubin, HBV DNA and the proportion of severe liver damage were higher than those of HBeAg positive. The immune indexes above-mentioned had no significant differences between two groups. Conclusions With older age and severer liver damage, HBeAg negative CHB patients should accept antiviral therapy more urgently. We may monitor the dynamic changes of HBsAg degrees, ALT and HBV DNA loads in order to predict the efficiency of antiviral therapy.%目的：总结HBeAg阳性与HBeAg阴性慢性乙型肝炎的临床特点及免疫状态。方法将234例慢性乙型肝炎患者按照HBeAg阳性或阴性，分为HBeAg阳性组和HBeAg阴性组，比较两组患者的年龄、性别、病情严重程度、肝功能、HBV DNA及免疫球蛋白、补体及T淋巴细胞亚群等免疫指标有无差异。结果 HBeAg阴性组和HBeAg阳性组相比，发病年龄更大（F =33.075，P =0.000），HBV DNA载量更低（F =56.429，P =0.000），总胆红素水平更高（F =4.187，P =0.042），重度及重型患者比例略高，但各项免疫指标比较无统计学差异。结论 HBeAg阴性CHB患者较HBeAg阳性者的年龄更大，而肝功能损害更重，存在更迫切的抗病毒治疗指征，可联合监测HBsAg、ALT及HBV DNA水平的动态变化以预测抗病毒疗效。
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