慢性乙肝病毒携带者血清HBeAg及HBV-DNA与肝组织病理改变的关系  

Relationship between serum HBeAg、HBV-DNA and liver pathological change in chronic hepatitis B virus carriers

作　　者：陈仕祥[1] 何维新[1] 熊志远[1] 范平[1] 江军[1] 

机构地区：[1]解放军113医院感染科,浙江宁波315040

出　　处：《中国误诊学杂志》2011年第15期3529-3531,共3页Chinese Journal of Misdiagnostics

摘　　要：目的了解慢性乙型肝炎病毒携带者肝组织病理改变特征,并分析血清HBeAg及HBV-DNA定量与肝组织病理改变的关系。方法选取临床诊断为慢性乙型肝炎病毒携带者228例,行肝穿刺病理检查、肝功能、血清HBV-DNA及乙肝血清学标志物检测。结果 228例患者中病理符合病毒携带者49例(21.5%),肝硬化7例(3.1%),慢性乙型肝炎轻度136例(59.6%),中度28例(12.3%),重度7例(3.1%),重型1例(0.4%)。炎症分级G≥2者43例(18.8%);纤维化分期S≥2者49例(21.5%)。HBeAg阴性组病理炎症分级及纤维化分期均明显重于阳性组(P值均小于0.05)。HBV-DNA低载量组纤维化分期重于高载量组,而两组间肝组织炎症分级无统计学意义。结论多数慢性乙型肝炎病毒携带者有不同程度病理变化,血清HBeAg、HBV-DNA均不能准确反映肝脏损伤情况,对此类患者制定治疗方案时应考虑肝组织病理检查结果。Objective To explore the relationship between serum HBeAg、the qualification of HBV-DNA and the liver patho1ogic change in chronic hepatitis B virus（HBV）carriers.Methods 244 cases of chronic hepatitis B virus carriers were examined with Liver biopsy、liver function、HBV-DNA level and serological markers of B-hepatitis examination.Results All of the 228 cases,49（21.5%） cases of chronic hepatitis B virus arriers,7 cases of cirrhosis（3.1%）,136 slight CHB（59.6%） and 28 moderate CHB（12.3%） and 7 severe CHB（3.1%） were detected.43（18.8%） had inflammation stage G≥2,49（21.5%） had fibrosis stage S≥ 2.The inflammation and fibrosis stages in HBeAg negative group were more severe than HBeAg positive group（P0.05）.The fibrosis stages in HBV-DNA low groups were severe than HBV-DNA high groups（P0.05）.No significant differences were observed in the inflammation between HBV-DNA high/low groups.Conclusion Most chronic HBV carriers have different degrees of liver pathological change.Serum HBeAg and HBV-DNA are unable to reflect the real condition of liver injury.Liver pathological results should be considered before a treating plan was chosen.

关 键 词：肝炎e抗原 乙型/血液 肝炎病毒 乙型/遗传学 肝/病理学 肝炎 乙型 慢性/病理学 

分 类 号：R512.62[医药卫生—内科学]