1686例慢性乙型肝炎中HBeAg阴性与阳性患者临床和病毒学特点比较分析  

A comparison of clinical and virological characteristics of 1686 cases of HBeAg-negative and HBeAg-positive chronic hepatitis B

作　　者：杨创国[1] 于乐成[1] 陈金军[1] 孙剑[1] 郭亚兵[1] 骆抗先[1] 朱幼芙[1] 侯金林[1] 

机构地区：[1]南方医科大学南方医院感染内科及肝病中心,广州510515

出　　处：《中华内科杂志》2005年第9期648-651,共4页Chinese Journal of Internal Medicine

基　　金：国家自然科学基金(30471549);国家杰出青年基金(30225042)资助课题

摘　　要：目的通过大样本横断面回顾性调查,了解HBeAg(-)和HBeAg(+)两类慢性乙型肝炎(CHB)患者临床相关因素的异同。方法对1686例CHB患者的住院病历进行回顾性调查,分析HBeAg(-)和HBeAg(+)CHB患者ALT、HBV DNA定量、肝组织病理(炎症及纤维化)等指标的组内和组间差异。结果HBeAg(-)CHB628例,占37·3%;HBeAg(+)CHB1058例,占62·7%。HBeAg(+)组ALT、HBV DNA总体上均高于HBeAg(-)组。HBeAg(+)组肝组织炎症及纤维化程度总体上均轻于HBeAg(-)组。结论目前我国CHB病例以HBeAg(+)者占多数。无论HBeAg(-)或HBeAg(+)CHB,肝炎活动在病毒复制活跃时均重于病毒复制水平较低时。HBeAg(-)CHB肝组织学损害重于HBeAg(+)CHB。Objective To investigate the clinical characteristics of HBeAg- negative and HBeAgpositive chronic hepatitis B （CHB）. Methods A total of 1686 hospitalized CHB cases were analyzed retrospectively. The serum ALT values, HBV DNA levels and hepatic inflammation and fdirosis were analyzed by their serum HBeAg status. Results Among the 1686 cases, 628 （ 37. 3% ） were HBeAg- negative and 1058 （62.7%） were HBeAg-positive. Compared with HBeAg-positive group, HBeAg-negative group had a lower serum ALT and HBV DNA levels. However, hepatic necroinflammation grading and fibrosis staging in HBeAg-negative group were more advanced than that of HBeAg-positive group. Irrespective to serum HBeAg status, patients with serum HBV DNA less than 10^5copies/ml, had a lower hepatic necroinflammation activity. Conclusions HBeAg-positive CHB is still the predominant form of CHB in Chinese patients. Compared with patients with low HBV replication, patients with active HBV replication had a higher hepatic necroinflammation activity. The liver histological grading and staging in HBeAg-negative CHB patients were more advanced than that in HBeAg-positive patients.

关 键 词：肝炎 乙型 慢性 肝炎E抗原 乙型 DNA 组织学 丙氨酸氨基转移酶 慢性乙型肝炎 临床相关因素 

分 类 号：R512.62[医药卫生—内科学] R595.1[医药卫生—临床医学]