乙型肝炎病毒e抗原阳性慢性乙型肝炎病毒感染者5年随访结果  

Five-year follow-up study on hepatitis B e antigen positive chronic hepatitis B virus carriers

作　　者：邓俊[1] 王娟华[1] 陆忠华[1] 秦菲[1] 黄利华[1] 陈卫[1] 

机构地区：[1]无锡市传染病医院肝病科,214005

出　　处：《中华传染病杂志》2009年第11期677-679,共3页Chinese Journal of Infectious Diseases

摘　　要：目的了解HBeAg阳性慢性HBV感染者的转归情况。方法对168例HBeAg阳性慢性HBV感染者进行为期5年的临床症状、肝组织活检及血清学检查的动态观察研究，率的比较采用χ2检验。结果在5年随访期间，168例HBeAg阳性慢性HBV感染者中有23例出现乙型肝炎活动，占13．7％，其中肝脏病理有明显炎性反应（≥G2）者乙型肝炎活动率为24．1％（21／87例），而原肝组织炎症活动度分级为G0～G1者活动率为2．5％（2／81例），两者比较差异有统计学意义（χ2=14．88，P〈0．01）。43例感染者行2次肝组织活检，原肝组织正常者几年内相对稳定，病理很少变化，原病理炎性反应较重者不易恢复，但可在小范围内波动。45例发生HBeAg血清转换，HBeAg年转阴率为5．4％。14例HBsAg转阴，年转阴率为1．67％。结论HBeAg阳性慢性HBV感染者乙型肝炎活动与肝脏炎症活动度分级密切相关。Objective To evaluate the clinical outcome of hepatitis B e antigen （HBeAg） positive chronic hepatitis B virus （HBV） carriers. Methods One hundred and sixty-eight chronic HBV carriers with HBeAg positive were followed up for 5 years. The clinical symptoms, liver biopsy and serological tests were observed. The data were analyzed using chi square test. Results Among 168 patients, 23 （13.7%） showed hepatitis B reactivation during 5-year follow up period. The hepatitis B reactivation rate in patients with obvious hepatic tissue inflammation （≥G2） was 24. 1% （21/87） and that in patients with mild hepatic tissue inflammation （G0-G1） was 2.5% （2/81）, which were significantly different χ2 = 14. 88, P〈0. 01）. Forty-three cases received paired liver biopsy, which indicated that patients with normal hepatic tissue kept stable for several years, while those with severe hepatic inflammation were difficult to recover and fluctuated slightly. Forty-five carriers developed HBeAg seroeonversion and HBeAg loss rate per year was 5.4 0~. Fourteen carriers developed hepatitis B surface antigen （HBsAg） loss with annual rate of 1.67%. Conclusion Hepatitis B reactivation of HBeAg positive chronic HBV carriers is closely related with liver inflammation grade.

关 键 词：肝炎e抗原 乙型 肝炎 乙型 慢性 活组织检查 随访研究 

分 类 号：R686[医药卫生—骨科学]