317例慢性乙型肝炎患者血清HBeAg、肝组织内HBsAg和HBcAg表达强度与临床的关系

摘要

目的 分析血清HBeAg阴性和阳性的慢性乙型肝炎(CHB)患者肝组织内的HBsAg、HBcAg表达强度与临床的关系.方法 31 7例CHB患者肝穿刺标本分成血清HBeAg阴性组和HBeAg阳性组两组,分析两组肝组织内HBsAg、HBcAg的表达强度及其与年龄、性别、血清丙氨酸氨基转移酶(ALT)、血清HBV DNA载量、肝脏炎症活动度分级和纤维化分期的关系.结果 HBeAg阴性组患者的年龄、ALT、肝脏炎症活动度和纤维化程度大于HBeAg阳性组患者;但血清HBV DNA载量低于HBeAg阳性组患者(均P＜0.05).肝组织内HBsAg表达强度与年龄、ALT、肝脏炎症程度和纤维化程度均无相关性(P＞0.05).血清HBeAg转阴后,肝组织内HBcAg表达强度降低(t=12 349.0,P=0.00);HBcAg与血清HBV DNA载量出现正相关关系(r=0.251,P=0.007);与肝脏炎症活动度和纤维化负向相关性消失(P＞0.05).结论 血清HBeAg转阴后HBV其他抗原成分仍能与肝组织维持足够活跃的免疫状态.血清HBeAg转阴后,肝组织内HBcAg表达强度降低,与血清HBV DNA载量出现正相关关系,与肝脏炎症活动度和纤维化负向相关性关系弱化.%Objective The relationship was analyzed between clinic and the expression intensity of HBsAg and HBcAg with in the hepatic tissue from the serum HBeAg negative group and the positive group.Methods A total of 317 liver biopsy specimens were divided into the HBeAg negative group and the positive group,and the relationship was analyzed between the expression inten sity of HBsAg and HBcAg within the hepatic tissue and their age,gender,ALT level,serum HBV-DNA load,hepatic inflammatory activity grading and fibrosis staging in the two groups.Results Age,ALT level,hepatic inflammatory activity grading and fibrosis of the serum HBeAg negative patients were greater than those of the serum HBeAg positive patients,while their serum HBV-DNA load and the expression intensity of HBcAg within the hepatic tissue were lower than those of the serum HBeAg positive patients (P＜0.05).The expression intensity of HBsAg within the hepatic tissue between the serum HBeAg patients and the serum HBeAg positive patients was not significantly different,and it was not correlated with age,ALT level,hepatic inflammatory grading and fi brosis staging (P＞0.05).After the serum HBeAg turned negative,the expression intensity of HBcAg within the hepatic tissue was decreased (P=0.00,t=12 349.0),and it became positively correlated with the serum HBV DNA load(P=0.007,r=0.251) and its negative correlation with the hepatic inflammatory activity and fibrosis was weakened.Conclusion After the serum HBeAg turned negative,other antigenic components of HBV may still maintain the adequately active immune status within the hepatic tis sue of organisms.After the serum HBeAg turned negative,the expression intensity of HBcAg within the hepatic tissue was de creased and became positively correlated with the serum HBV DNA,while its negative correlation with the hepatic inflammatory activity grade and fibrosis stagings was weakened.