乙型肝炎患者血清HBeAg和HBV-DNA载量与临床分型及病理分级分期的关系

Research on correlation between histological grading and staging of intrahepatic inflammation in hepatitis B patients and contents of serum HBV-DNA and HBeAg

目的 探讨乙型肝炎患者血清中乙型肝炎病毒e抗原 (HBeAg)和乙型肝炎病毒脱氧核糖核酸 (HBV DNA)载量与其临床分型及病理分级分期的关系。方法 检测 2 97例未经抗病毒治疗的各型乙型肝炎患者血清HBeAg和HBV DNA载量 ,并对其中 4 9例HBeAg和HBV DNA阳性的慢性乙型肝炎患者进行了肝组织活检。 结果 临床各型乙型肝炎中除慢性乙型肝炎轻度外 ,其余各组HBV DNA与HBeAg阳性率比较 ,差异有统计学意义 (P <0 .0 1) ;急性乙型肝炎、慢性乙型肝炎轻度、慢性乙型肝炎中度、慢性乙型肝炎重度、肝硬化、重型肝炎的HBeAg载量(Ncu/ml)和HBV DNA载量 (对数值 )分别为 (0 .31± 0 .2 7)、(0 .5 5± 0 .30 )、(0 .4 9± 0 .36 )、(0 .78± 0 .76 )、(0 .6 8±0 .5 6 )、(0 .80± 0 .95 )和 (6 .4 4± 1.4 1)、(7.0 8± 1.2 4 )、(7.35± 1.13)、(6 .78± 1.4 3)、(6 .4 7± 1.2 3)、(7.0 9± 1.4 0 ) ,慢性乙型肝炎轻度、慢性乙型肝炎中度、慢性乙型肝炎重度、肝硬化、重型肝炎各组间的HBeAg和HBV DNA载量比较 ,差异无统计学意义 (P >0 .0 5 ) ;肝脏病理炎症分级G1、G2 、G3 、G4之间以及纤维化分期S1、S2 、S3 、S4之间HBeAg和HBV DNA载量比较 ,差异均无统计学意义 (P >0 .0 5 )。结论 乙型肝炎患者血清HBeAg和HBV

Objective To explore the correlation between the histological grade and staging of intrahepatic inflammation in hepatitis B patients and the contents of serum HBV-DNA and HBeAg.Methods To detect the contents of HBV- DNA and HBeAg in 297 cases of hepatitis B(HB) who have not received anti-virus,and to detect the hepatic biopsy among 49 cases of positive serum HBV- DNA and HBeAg in chronic HB patients.Results In chronic HB,positive ratio of serum HBeAg and HBV-DNA was significantly different (P< 0.01),but mild chronic HB was not.In acute HB,mild,medium and severe chronic HB,cirrhosis and severe HB,the contents of serum HBeAg(Ncu/ml) and HBV-DNA(logarithm value) were ( 0.31± 0.27),( 0.55± 0.30),( 0.49± 0.36),( 0.78± 0.76),( 0.68± 0.56),( 0.80± 0.95) and ( 6.44± 1.41),( 7.08± 1.24),( 7.35± 1.13),( 6.78± 1.43),( 6.47± 1.23),( 7.09± 1.40),the contents of HBeAg and HBV-DNA were not significantly different in mild,medium,severe chronic HB,cirrhosis and chronic severe hepatitis(P> 0.05).Grade of intrahepatic inflammation G1,G2,G3,G4 and staging of fibrosis were compared one by one,each group′s contents of HBeAg and HBV- DNA were not obviously difference (P> 0.05).Conclusion There is no certain correlation between the contents of serum of HBeAg and HBV- DNA of HB patients and their course and severity degree of patients′ condition,there is no significant correlation between grade of intrahepatic inflammation and staging of fibrosis.