HBeAg阳性与阴性乙型肝炎肝硬化患者乙肝病毒载量及肝功能指标的研究  

Study on hepatitis B virus load and liver function indices in patients with HBeAg-positive and HBeAg-negative hepatitis B cirrhosis

作　　者：张国顺 孟冬梅 方正亚 刘斌 Guo-shun Zhang;Dong-mei Meng;Zheng-ya Fang;Bin Liu(Department of Gastroenterology, the Afliated Hospital of North China University of Science and Technology, Tangshan, Hebei 063000, Chin)

机构地区：[1]华北理工大学附属医院消化内科,河北唐山063000

出　　处：《中国现代医学杂志》2018年第16期48-51,共4页China Journal of Modern Medicine

摘　　要：目的探讨乙肝e抗原(HBeAg)阳性与阴性乙型肝炎肝硬化患者病毒载量及肝功能指标的差异并分析其临床意义。方法采用回顾性分析方法,收集2015年2月-2016年2月在该院住院的乙型肝炎肝硬化患者270例,分析HBeAg阳性(124例)和HBeAg阴性(146例)乙型肝炎肝硬化患者的乙肝表面抗原(HBsAg)、HBV DNA、肝功能指标(ALT、AST、TBIL、ALB)的差异及不同HBV DNA载量的构成比。结果 HBe Ag阳性组HBsAg、HBV DNA、ALT、AST的含量与HBe Ag阴性组比较,差异有统计学意义(P<0.05),HBeAg阳性组均高于HBeAg阴性组的患者;两组间TBIL、ALB的比较,差异无统计学意义(P>0.05)。HBeAg阳性组HBV DNA<103 IU/ml及103~105 IU/ml患者的比例均低于HBeAg阴性组;HBeAg阳性组HBV DNA>105 IU/ml患者的比例高于HBe Ag阴性组,两组间HBV DNA水平的构成比差异有统计学意义(P<0.05)。结论随着乙肝肝硬化患者体内HBeAg的血清学转换,乙肝病毒复制水平降低,肝脏炎症反应减弱,但并不意味着病情得到控制,有可能肝脏损害逐渐加重,仍需积极抗病毒治疗。Objective To investigate the differences of HBV load and liver function indexes between HBeAgpositive and HBeAg-negative hepatitis B cirrhosis patients and to analyze its clinical significance. Methods In this retrospective study, 270 cases of liver cirrhosis were collected from February 2015 to February 2016 in the Affiliated Hospital of North China University of Science and Technology. The differences of HBs Ag, HBV DNA, liver function indexes（ALT, AST, TBIL and ALB） and the composition ratio of different HBV DNA loads between the HBeAg-positive（124 cases） and HBeAg-negative（146 cases） patients with hepatitis B cirrhosis were analyzed. Results The content of HBs Ag, HBV DNA, ALT and AST in the HBeAg-positive group apparently exceeded that in the HBeAg-negative group（P〈0.05）. There was no significant difference in TBIL or ALB between the two groups（P〉0.05）. The proportions of the patients with HBV DNA below 103 IU/ml and between 103 and 105 IU/ml in the HBeAg-positive group were lower than those in the HBeAg-negative group. The proportion of the patients with HBV DNA over 105 IU/ml in the HBeAg-positive group was higher than that in the HBeAg-negative group, there was a significant difference in the ratio of HBV DNA between the two groups（P〈0.05）. Conclusions With seroconversion of HBeAg in the patients with hepatitis B cirrhosis, the level of hepatitis B virus replication decreases and the liver inflammatory response is reduced, but it does not mean that the disease is under control. It is possible that the liver damage will aggravate gradually, and active antiviral therapy is still necessary.

关 键 词：乙型肝炎肝硬化 乙肝E抗原 乙肝病毒DNA 肝功能 

分 类 号：R575.2[医药卫生—消化系统]