HBeAg(-)乙型肝炎后肝硬化的临床特征

Clinical characteristics of patients with hepatocirrhosis after HBeAg-negative hepatitis B

目的:探讨HBeAg(-)乙型肝炎后肝硬化患者临床特征．方法:我院2005=01/06,肝硬化住院患者371例,分为A,B,C三组,分别为HBVDNA(+)HBeAg(+), HBVDNA(+)HBeAg(-),HBVDNA(-) HBeAg(-)3组进行分析．观察癌变发生率、重症肝炎发生率,肝功能及血脂等指标．结果:B组癌变率明显高于A,C组(31．3％vs 19．2％,18．2％,均P<0．05);重症肝炎发生率三组间无显著差异(P>0．05);ALB、PAB、CHE 在C,B,A三组间依次降低,A组降低最明显, 与其他B,C组差异呈高度显著性(P<0．05)．血脂4项检测在C组最高,与A,B组之间的差异呈高度显著性(P<0．05)．TBA在A,B,C三组间依次降低(96．89±101．44,76．46±83．80, 58．92±77．17μmol／L),相互之间有显著性差异(P<0．01)．平均病毒载量A组明显高于B,C 组,有显著性差异(2．5×107 vs 7．7×106,0, P<0．05)．结论:HBVDNA(+)HBeAg(-)乙型肝炎后肝硬化患者癌变率高;肝脏受损程度介于 HBeAg(+)DNA(+)组和HBeAg(-)DNA(-)组之间．

AIM： To conclude the clinical characteristics of hepatocirrhosis after HBeAg-negative hepatitis B （liB）. METHODS： Three hundred and seventyone patients with hepatocirrhosis after HB, from January to June in 2005, in Beijing Ditan Hospital, were classified into three groups： HBVDNA（＋）HBeAg（＋）, HBVDNA（＋）HBeAg（-）, and HBVDNA（-）HBeAg（-）, named group A, B, and C, respectively. The incidence rates of severe hepatitis and liver cancer, liver traction and the level of blood lipid were observed. RESULTS： The incidence rate of liver cancer was significantly higher in group B than that in group A or C （31.3% vs 19.2%, 18.2%, both P 〈 0.05）. The incidence rate of severe hepatitis was not significantly different between all the groups. The levels of albumin （ALB）, proalbumin （PAB）, and cholinesterase （ChE） were reduced remarkably in group A （P 〈 0.05）, while the level of blood lipid in group C was higher than that in group A or B （P 〈 0.05）. The level of total bile acid （TBA） was 96.89 ± 101.44, 76.46 ± 83.80, and 58.92 ± 77.17 μmol/L, respectively, in group A, B and C, and significant difference existed between each groups （P 〈 0.01）. Mean virus load was markedly higher in group A than that in group B or C （2.5×10^7 vs 7.7×10^6, 0, P 〈 0.05）. CONCLUSION： Hepatocirrhosis after HBVDNA（＋）HBeAg（-） HB has a high incidence rate of Ever cancer, and liver injury is lighter than that after HBVDNA（＋）HBeAg（＋） HB, but more severe than that after HBVDNA（-）HBeAg（-） HB.