论文部分内容阅读
目的:探讨乙型肝炎患者HBsAg与HBsAb同时阳性少见模式产生的原因与临床意义。方法:筛选有完善的病史资料、及多次不同时段复查结果的HBsAg与HBsAb同时阳性病例209例纳入统计分析。分析HBsAg与HBsAb同时阳性患者的临床诊断、HBVM(乙肝血清标志物)模式分布、HBV-DNA的阳性率、肝功能状况、治疗用药情况。结果:HB-sAg与HBsAb同时阳性病例HBVM模式分布以①②③⑤为主占54.5%。HBsAg与HBsAb同时阳性组与对照组②的HBsAb的滴度差异具有显著性,与对照组①在HBV-DNA阳性率和肝功能异常率方面无显著性差异。诊断为慢性乙肝的患者占HBsAg与HBsAb同时阳性病例的78.5%。结论:HBsAb的产生在HBsAg与HBsAb同时阳性患者中并非预示乙肝病情的恢复。HBV病毒的变异受多种因素影响。乙肝病情反复不逾,以及持续的治疗可能会引起HBV(乙型肝炎)病毒S区基因突变的累积,从而造成HBsAg与HBsAb同时阳性现象。
Objective: To investigate the causes and clinical significance of the rare simultaneous positive HBsAg and HBsAb patterns in hepatitis B patients. Methods: A total of 209 cases with simultaneous positive cases of HBsAg and HBsAb were screened with a good history data and multiple reexaminations at different times. The clinical diagnosis, HBVM (Hepatitis B serological markers) pattern distribution, the positive rate of HBV-DNA, liver function status and treatment medication were analyzed in patients with positive HBsAg and HBsAb simultaneously. Results: The distribution of HBVM patterns in HBsAg-positive and HBsAb-positive cases was mainly ①②③⑤ (54.5%). HBsAg and HBsAb positive group and control group ② HBsAb titer difference was significant, and the control group ① in HBV-DNA positive rate and liver dysfunction rate was no significant difference. Patients diagnosed with chronic hepatitis B accounted for 78.5% of those with positive HBsAg and HBsAb. CONCLUSIONS: HBsAb production does not predict recovery from hepatitis B in HBsAg and HBsAb-positive patients. Variants of the HBV virus are affected by many factors. Repeated failure of hepatitis B and persistent treatment may result in the accumulation of mutations in the S region of the HBV (hepatitis B) virus, resulting in a simultaneous positive result of HBsAg and HBsAb.