慢性乙型肝炎患者血清HBeAg、HBVDNA与肝组织炎症关系的探讨

Analysis of relationship between HBeAg and HBV DNA levels and grading of liver inflammation in patients with chronic hepatitis B

目的探讨慢性乙型肝炎血清HBeAg及HBV DNA水平和肝组织炎症损害的关系.方法采用微粒子免疫捕捉分析法和荧光定量聚合酶链反应分别对74例HBeAg阴性和73例HBeAg阳性慢性乙型肝炎患者进行血清HBeAg、HBV DNA定量检测和肝组织活检病理炎症分级,对比分析结果.结果74例HBeAg阴性慢性乙型肝炎患者中27例(36%)血清HBV DNA＞105拷贝/ml,随着G1～G4肝组织炎症损害级别的增高其所占例数也相应增高,统计学分析HBV DNA水平与肝组织炎症病理分级的相关性有显著意义;血清HBeAg定量0～29 PEIU/ml,随肝组织炎症病理分级上升定量阳性(＞0.28 PEIU/ml)的病例比率增加,经统计学分析两者具有相关性.73例HBeAg阳性慢性乙型肝炎患者中有49例(67%)血清HBV DNA＞105拷贝/ml,血清HBeAg及HBV DNA水平与肝组织炎症分级无相关性.结论血清HBV DNA水平可作为判断HBeAg阴性慢性乙型肝炎患者肝组织炎症损害程度的指标,血清HBV DNA水平愈高肝组织炎症损害往往愈重.36%的HBeAg阴性慢性乙型肝炎患者血清HBeAg水平低下而HBV DNA复制活跃,可能存在HBV的前C区终止突变合并C区突变.血清HBV DNA水平不能反映HBeAg阳性慢性乙型肝炎肝组织炎症损害的程度.

Objective To determine the relationship between HBeAg and HBV DNA levels and grading of liver inflammation in patients with chronic hepatitis B. Methods Serum HBeAg and HBV DNA were assayed by MEIA and PCR in 74 patients with HBeAg-negative and 73 patients with HBeAg-positive chronic hepatitis B who had undergone liver biopsy and pathological grading. Results The serum HBV DNA levels in 27 patients （36 % ） HBeAg negative chronic hepatitis B were higher 10^5 copies/ml. The number of patient at the HBV DNA level increase along with G1-G4 grading ascendant. The correlation between two factors has statistically remarkable significance. Those serum HBeAg quantitative levels are 0-29 PEIU/ml. The number of HBeAg quantitative-positive patients increase also along with G1-G4 grading ascendant and the correlation between two items has statistically significance. However, there are no relationship between serum HBeAg and HBV DNA and G1-G4 grading in 73 patients with HBeAg positive chronic hepatitis B whose HBV DNA levels are higher than 10^5 copies/ml. Conclusions Serum HBV DNA level is the indicator by which grading of liver inflammation can be judged in the patients with HBeAg-negative chronic hepatitis B and former is positively interrelated with latter significantly. That Serum HBeAg level is low but HBV DNA duplicate actively may indicate that there is C-zone mutation in 36% patients with HBeAg-negative chronic hepatitis B . Serum HBV DNA level cannot reflect grading of liver inflammation in the patients with HBeAg-positive chronic hepatitis B.