HBeAg阳性和阴性慢性乙型肝炎患者肝组织病理结果分析158例  

Pathological characteristics of chronic hepatitis B in HBeAg-positive and HBeAg-negative patients: An analysis of 158 cases

作　　者：马俊骥[1,2] 冯丽英[1,2] 冯志杰[1,2] 姜慧卿[1,2] 孙泽明[1,2] 赵丽梅[1,2] 

机构地区：[1]河北医科大学第二医院消化内科 河北省消化病实验室 [2]河北省消化病研究所,河北省石家庄市050000

出　　处：《世界华人消化杂志》2013年第18期1766-1771,共6页World Chinese Journal of Digestology

基　　金：国家自然科学基金资助项目;Nos.81200311;81170411~~

摘　　要：目的:评估乙型肝炎E抗原(hepatitis be e antigen,HBeA g)阳性和阴性慢性乙型肝炎(chronic hepatitis B,CHB)患者肝组织病理存在的差异,并分析其与临床基本资料的关系.方法:病例资料来自2005-01/2012-12在河北医科大学第二医院消化内科住院并做肝脏活组织检查的CHB患者.根据乙型肝炎病毒(hepatitis B virus,HBV)血清标志物乙型肝炎表面抗原(hepatitis B surface antigen,HBsAg)和HBeAg区分HBeAg阳性和HBeAg阴性CHB患者,同时记录性别、年龄、谷丙转氨酶(alanine aminotransferase,ALT)和HBV DNA病毒载量,并进行统计分析.统计学处理采用SPS13.0统计软件,计量资料采用mean±SD表示,两样本均数的比较,如为正态分布用t检验,偏态分布用Mann-Whitney检验,多组计量资料的两两比较采用ANOVA检验.相关性分析采用Pearson检验.计数资料采用2检验.结果:158例CHB患者根据血清标志物HBeAg分为HBeAg阳性组86例和HBeAg阴性组72例,两组年龄差异有统计学意义(t=-7.50,P<0.01),性别比例差异无统计学意义(2=0.10,P>0.05).HBeAg阳性组与HBeAg阴性组在肝脏纤维化分期构成比上存在统计学差异(2=20.79,P<0.01).HBeAg阳性组女性纤维化分期积分比男性低(1.48±0.69vs2.09±1.29,P<0.05).HBeAg阳性组40岁以上CHB患者炎症分级及纤维化分期积分(2.93±1.03和2.67±1.23)均高于30-40岁组(2.09±1.27和1.86±1.25)和30岁以下年龄组(2.16±0.69和1.65±0.99),有统计学意义(P<0.05).HBeAg阴性组30岁以下CHB患者纤维化分期积分(1.57±0.98)明显低于30-40岁组(2.73±1.37)和40岁以上年龄组(3.03±1.06),有统计学意义(P<0.05).在HBeAg阳性,年龄与炎症分级和纤维化分期积分均成正相关(r=0.30,0.34,P<0.01).在HBeAg阴性组,年龄与炎症分级和纤维化分期积分也均成正相关(r=0.26,0.34,P<0.05).HBeAg阳性组ALT与炎症分级和纤维化分期积分均成正相关(r=0.32、0.24,P<0.05);在HBeAg阴性组,ALT与炎症分级积分成正相关(r=0.33,P<0.01),与纤维化分期AIM： To find the differences in liver histopathology between HBeAg-positive and HBeAg -negative patients with chronic hepatitis B （CHB）, and to analyze their relationship with clinical data. METHODS： CHB patients （n = 158） who were admitted to the Second Hospital of Hebei Medical University for a liver biopsy from January2005 to December 2012 were enrolled. They were divided into an HBeAg-positive （n = 86） and an HBeAg-negative group （n = 72） based on the presence of HBeAg or not. Gender, age, alanine aminotransferase （ALT） and HBV DNA viral load were recorded and statistically analyzed with SPSS l3.0. RESULTS： The age differed significantly between the HBeAg-positive group and HBeAgnegative group （t = -7.50, P 0.01）, although there was no statistically significant difference in sex ratio between the two groups （ 2 = 0.10, P 0.05）. A significant difference was noted in the constituent ratio of liver fibrosis stages between the two groups （ 2 = 20.79, P 0.01）. The fibrosis stage score in HBeAg-positive women was lower than that in men （1.48 ± 0.69 vs 2.09 ± 1.29, P 0.05）. For HBeAg-positive patients, both inflammation grade and fibrosis stage scores were significantly higher in the 40 years age group than in the 30-40 years age group and 30 years age group （2.93 ± 1.03 vs 2.09 ± 1.27, 2.16 ± 0.69; 2.67 ± 1.23 vs 1.86 ± 1.25, 1.65 ± 0.99, all P 0.05）. For HBeAg-negative patients, fibrosis stage score was significantly lower in the 30 years age group than in the 30-40 years age group and 40 years age group （1.57 ± 0.98 vs 2.73 ± 1.37, 3.03 ± 1.06, both P 0.05）. In the HBeAgpositive group, there was a positive correlation between age and inflammation grade or fibrosis stage score （r = 0.30, 0.34, both P 0.01）. In the HBeAg-negative group, there was also a positive correlation between age and inflammation grade or fibrosis stage score （r = 0.26, 0.34, both P 0.05）. In the HBeAg-positive group, ALT levels were positively correlated with inflammati

关 键 词：慢性乙型肝炎 乙型肝炎病毒 乙型肝炎E抗原 肝脏病理 谷丙转氨酶 

分 类 号：R512.62[医药卫生—内科学]