HBeAg与抗-HBe双阳性的慢性乙型肝炎患者临床特征分析  

Clinical characteristics of chronic hepatitis B patients with both HBeAg and HBeAb positive

作　　者：罗琳 张廷超 刘书刚 LUO Lin;ZHANG Tingchao;LIU Shugang(Laboratory Department,Guangyuan Hospital of Traditional Chinese Medicine,Guangyuan,Sichuan,China,628000)

机构地区：[1]广元市中医医院检验科，四川 广元 628000

出　　处：《分子诊断与治疗杂志》2019年第5期387-390,433,共5页Journal of Molecular Diagnostics and Therapy

基　　金：广元市科技计划项目(2017ZCZDYF3912)

摘　　要：目的探讨乙型肝炎e抗原(HBeAg)与抗?HBe(HBeAb)双阳性的慢性乙型肝炎患者临床特征。方法选择2016年1月至2017年12月在本院诊断治疗的慢性乙型肝炎患者500例为研究对象。根据HBeAg与抗?HBe阳性结果进行分组,其中双阳性组122例,e抗原阳性组173例,e抗体阳性组205例,比较3组HBeAg、抗?HBe、HBV DNA拷贝水平分布情况;比较各组肝功能指标、AFP结果异常比例。结果双阳性组68.0%患者HBeAg在1~10^.0 COI,只有0.8%患者>10^0.0 COI,与e抗原阳性组比较差异有统计学意义(P<0.05)。双阳性组63.9%患者抗?HBe在0~1.0 COI,只有12.3%患者0~0.1 COI,与e抗原阳性组比较差异有统计学意义(P<0.05)。双阳组64.8%患者HBV DNA定量水平在5×10^2~1×10^7拷贝/mL,4.9%>1×10^7拷贝/mL;e抗原阳性组18.9%>1×10^7拷贝/mL,e抗体阳性组无>1×10^7拷贝/mL的病例,3组比较差异有统计学意义(P<0.05)。双阳组ALT异常率40.2%,TBA异常率为43.4%,AFP异常率为32.0%显著高于e抗原阳性组与e抗体阳性组,差异有统计学意义(P<0.05)。结论HBeAg与抗?HBe双阳性的慢性乙型肝炎患者HBV DNA定量水平高,具有传染性,转氨酶水平更高,存在肝脏损伤,AFP水平更高,应引起足够重视。Objective To investigate the clinical features of hepatitis B e antigen(HBeAg)and anti?HBe(HBeAb)double positive chronic hepatitis B patients.Methods 500 patients with chronic hepati?tis B from January 2016 to December 2017 were selected as subjects,122 cases in group of both positive,173 cases in group of HBeAg positive,205 cases in group of HBeAb positive.The distribution of HBeAg,HBeAb and HBV DNA copies in the three groups was compared.The abnormal liver function index and AFP results were evaluated.Results In the double positive group,68.0%of patients had HBeAg of 1~10^.0 COI,and only 0.8%of patients had>10^0.0 COI,which was significantly different from the e antigen positive group(P<0.05).HBeAb of 63.9%cases in the group of both positive were 0~1.0 COI,and only 12.3%of patients had 0~0.1 COI,which was significantly different from the e?antigen?positive group(P<0.05).HBV DNA of 64.8%cases in the group of both positive were 5×10^2~1×10^7 copy/mL,and 4.9%cases were>1×10^7 copy/mL;18.9%cases in the group of HBeAg positive were>1×10^7 copy/mL,and no case in the group of HBeAb positive was>1×10^7 copy/mL;There was significant difference in the 3 groups(P<0.05).In the group of both positive,abnormality rate of ALT was 40.2%,TBA was 43.4%,and AFP was 32.0%,which were higher than those in the group of HBeAg positive and group of HBeAb positive(P<0.05).Conclusion CHB patients with HBeAg and HBeAb double positive show high HBV DNA level.They are infectious,have higher levels of transaminase,have liver injury and higher AFP level,which should be paid enough attention.

关 键 词：HBEAG 抗-HBE 慢性乙型肝炎 乙型肝炎病毒 肝功能 甲胎蛋白 

分 类 号：R51[医药卫生—内科学]