乙型肝炎e抗原阴性表面抗原携带者的危险因素及预防措施  

The risk factors and preventive measures of HBs Ag carriers of HBe Ag-negative hepatitis B

作　　者：温泉 施扬佳 李加位 

机构地区：[1]广西壮族自治区钦州市灵山县佛子镇卫生院,广西灵山535426 [2]广西壮族自治区钦州市灵山县卫生监督所,广西灵山535400 [3]广西壮族自治区钦州市灵山县檀圩镇中心卫生院,广西灵山535413

出　　处：《转化医学电子杂志》2017年第3期53-55,共3页E-Journal of Translational Medicine

摘　　要：目的:探讨乙型肝炎e抗原(HBe Ag)阴性、表面抗原(HBs Ag)阳性慢性乙型肝炎患者的危险因素及预防措施.方法:选取广西壮族自治区钦州市灵山县佛子镇卫生院感染性疾病科2013/01-2015/12收治的HBe Ag阴、阳性,且HBs Ag阳性慢性乙型肝炎共108例患者作为研究对象,对其进行血常规、尿常规、大便常规、生化全套、肝炎全套、梅毒、艾滋、彩超、心电图、胸片等常规检查,应用荧光定量聚合酶链反应、流式细胞仪进行HBV-DNA、T淋巴细胞亚群检测.结果:HBe Ag阴性慢性乙型肝炎患者常规检查出现异常的例数与HBe Ag阳性慢性乙型肝炎患者比较,差异无统计学意义(P>0.05).HBe Ag阴性、HBs Ag阳性患者HBV-DNA水平与CD8+T淋巴细胞呈正相关(r=0.686),而与CD4/CD8比值呈负相关(r=-0.508,P<0.05);与总T、CD4+T细胞无明显相关性.HBe Ag阳性、HBs Ag阳性组患者的HBV-DNA水平与总T、CD4+T、CD8+T淋巴细胞水平均无明显相关性.结论:HBe Ag阴性、HBs Ag阳性患者HBV-DNA水平与机体细胞免疫密切相关,应充分重视此类患者的诊断与治疗.AIM： To investigate the risk factors and preventive measures of HBsAg carriers of HBeAg-negative hepatitis B. METHODS： A total of 108 cases of patients with HBeAg-nega- tive, HBeAg-positive and HBsAg-positive chronic hepatitis B admitted into Prevention and Care Group of Fozi Township Hospital from January 2013 to December 2015 were selected as the objects of study. All the patients was given routine examinations such as blood routine, urine routine, routine stool, a full set of biochemistry examination, a full set of hepatitis examination, syphilis, HIV, color doppler ultrasound, electrocardiogram, chest radiograph and so on. HBV-DNA level was tested by fluorescent quantity PCR, and T lymphocyte subsets were examined by flow cytometry. RESULTS： There＇s no significant statistical difference on abnormal cases number bewtween patients with HBeAg-negative chronic hepatitis B and patients with HBeAg-positive chronic hepatitis B （P〉 0.05）. The HBV-DNA level in patients with HBeAg-nega- tire, HBsAg-positive chronic hepatitis B had a postive correlation with the CD8＋ T lymphocyte （ r =0. 686, P 〈 0.05 ）, a negative correlation with the ratio of CD4＋/CD8＋T lymphocyte （r=-0.508, P〈0.05）, and no remarkable correlation with the total T cells and CD4＋T lymphocyte. However, for patients with HBeAg-positive, HBsAg-positive chronic hepatitis B, there was no correlation betweenthe HBV-DNA level and the total T ceils, CD4＋T lympho- cyte, CD8＋T lymphocyte. CONCLUSION： HBV-DNA level is closely correlated with the cellular immune status in the patients with HBeAg-negative, HBsAg-positive chronic hepatitis B, it is necessary to pay attention to the diagnosis and treatment of these patients.

关 键 词：乙型肝炎 慢性 T淋巴细胞亚群 病毒 DNA 

分 类 号：R512.62[医药卫生—内科学] Q523[医药卫生—临床医学]