论文部分内容阅读
目的探讨HBeAg阴性和HBeAg阳性慢性乙型肝炎患者的临床病理学差异。方法选择2008年01—05月在北京佑安医院住院并作活体肝组织穿刺病理学诊断(肝穿)且诊断为慢性乙型肝炎的患者137例,其中HBeAg(+)组87例,HBeAg(-)组50例,对2组间的血清学指标及肝穿病理结果进行对比分析。结果①HBeAg(+)组和HBeAg(-)组HBV DNA阳性率比较有统计学差异(P=0.000 0);②HBeAg(+)组患者的ALT异常率要高于HBeAg(-)组,差异具有统计学意义(P=0.023);③HBeAg(+)组的病理炎症分级要重于HBeAg(-)组,差异具有统计学意义(P=0.0021),但2组间纤维化程度差异无统计学意义(P>0.05);④HBeAg(-)组中HBVDNA(+)组的病理炎症分级要重于HBVDNA(-)组,差异有统计学意义(P=0.007),但2组间纤维化程度差异没有统计学意义(P>0.05)。结论血清HBeAg阳性是判断HBV复制的良好指标。对HBeAg阴性患者应常规测定血清HBV DNA水平,筛查前C区变异。尤其应对HBeAg阴性且HBV DNA高水平的患者加以重视,结合肝穿结果综合评估病情以指导临床诊疗。
Objective To investigate the clinicopathological differences of HBeAg-negative and HBeAg-positive chronic hepatitis B patients. Methods One hundred and fourty-seven patients were enrolled in Beijing You’an Hospital from January to May in 2008 and were diagnosed as chronic hepatitis B by pathological diagnosis of liver biopsy. Among them, 87 patients were HBeAg (+), HBeAg -) group of 50 patients, the two groups of serum markers and liver biopsy results were compared. Results ① The positive rates of HBV DNA in HBeAg (+) and HBeAg (-) groups were significantly different (P = 0.000 0). ② The ALT abnormalities in HBeAg (+) group were higher than those in HBeAg (-) group, with statistical difference (P = 0.023). ③ The grade of pathological inflammation in HBeAg (+) group was higher than that in HBeAg (-) group, the difference was statistically significant (P = 0.0021), but there was no significant difference in the degree of fibrosis between the two groups (P = 0.007), but there was no statistical difference in the degree of fibrosis between the two groups (P> 0.05); ④ The HBVDNA (+) group in HBeAg (-) group was more severe than HBVDNA Significance (P> 0.05). Conclusion Serum HBeAg positive is a good indicator of HBV replication. Serum HBV DNA levels should be routinely measured in patients with HBeAg-negative and C-site variability prior to screening. In particular, should be HBeAg-negative and high levels of HBV DNA in patients with attention, combined with the results of liver wear comprehensive assessment of the disease to guide the clinical diagnosis and treatment.