论文部分内容阅读
目的 探讨ＨＢｅＡｇ阳性和抗－ＨＢｅ阳性的慢性乙型肝炎患者的肝组织病理改变的差异性。方法 分别对１５１例ＨＢｅＡｇ阳性和６２例抗－ＨＢｅ阳性的慢性乙型肝炎患者进行肝活检，观察肝组织病理分级和分期情况，同时检测血清ＨＢＶ ＤＮＡ。结果（１）肝组织病理分级、分期与血清ＨＢｅＡｇ／抗－ＨＢｅ的出现情况密切相关，抗－ＨＢｅ阳性者中肝组织病理为Ｇ３～Ｇ４、Ｓ３～Ｓ４者明显多于Ｇ１～Ｇ２、Ｓ１～Ｓ２者；而在ＨＢｅＡｇ阳性者中则相反；两组比较差异有显著性（Ｐ＜０．００５）；（２）在ＨＢｅＡｇ阳性患者中ＨＢＶ ＤＮＡ检出率为８３．４％（１２６／１５１）；而在抗－ＨＢｅ阳性患者中ＨＢＶ ＤＮＡ检出率为２９％（１８／６２）。结用（１）抗－ＨＢｅ阳性的慢性乙型肝炎患者中肝组织炎症、坏死及肝纤维化的程度较ＨＢｅＡｇ阳性者严重；（２）ＨＢｅＡｇ与ＨＢＶ ＤＮＡ存在良好的相关性，但在部分抗－ＨＢｅ阳性的患者中仍可检出ＨＢＶ ＤＮＡ。
Objective To investigate the difference of pathological changes of liver tissue between HBeAg-positive and anti-HBe-positive chronic hepatitis B patients. Methods 151 cases of HBeAg-positive and 62 cases of anti-HBe positive chronic hepatitis B patients were performed liver biopsy, pathological grading and staging of liver tissue were observed, and serum HBV DNA was detected at the same time. Results (1) The histopathological grade and staging of liver tissue were closely related to the appearance of serum HBeAg / anti-HBe. The histopathological features of G3 ~ G4 and S3 ~ S4 in anti-HBe positive group were more than that of G1 ~ G2, S2, but negative in HBeAg-positive patients (P <0.005). (2) The detection rate of HBV DNA in HBeAg-positive patients was 83.4% (126/151) ; HBV DNA detection rate was 29% (18/62) in anti-HBe positive patients. (1) The degree of hepatic inflammation, necrosis and liver fibrosis in patients with anti-HBe-positive chronic hepatitis B were more serious than that of HBeAg-positive patients. (2) There was a good correlation between HBeAg and HBV DNA. However, HBV DNA can still be detected in HBe positive patients.