乙型肝炎e抗原阴性和阳性慢性乙型肝炎患者临床转归的回顾性分析

A study on the long-term outcome of hepatitis B e antigen-negative chronic hepatitis B compared with that of hepatitis B e antigen-positive chronic hepatitis B

目的随访HBeAg阴性和HBeAg阳性慢性乙型肝炎的临床转归,为比较两者的预后提供佐证。方法采用回顾性分析.随访6～18年,平均(11.8±4.1)年,经肝穿刺病理组织学诊断,HBeAg阴性65例、HBeAg阳性118例慢性乙型肝炎患者的临床转归。统计学处理采用t检验和x^2检验。结果HBeAg阴性慢性乙型肝炎患者累汁发展为肝硬化7例。占10.8%,肝癌4例.占6.2%,死亡8例.占12.3%;HBeAg阳性慢性乙型肝炎患者累计发展为肝硬化15例.占12.7%,肝癌8例,占6.8%,死亡12例,占10.2%。两组相比,肝硬化、肝癌和死亡的发生率差异均无统汁学意义(均P>0.05)。结论HBeAg阴性和HBeAg阳性慢性乙型肝炎患者的远期临床转归差异无统计学意义。

Objective To compare the long-term outcomes between hepatitis B e antigen （HBeAg）-negative chronic hepatitis B（e-CHB） and hepatitis B e antigen-positive chronic hepatitis B （e＋CHB）. Method The clinical prognosis of sixty-five e-CHB patients, mean age （31.9±8.0） years, male ： female 52 ： 13, and one hundred and eighteen e＋CHB patients, mean age （31.1±7.2） years, male ： female 100 ： 18, diagnosed by biopsy were analysed by retrospective study. The mean follow-up time was （11. 8 ± 4. 1） years. This study was focused on long-term clinical outcomes including the rate of liver cirrhosis（LC） and hepatocellular carcinoma（HCC） and death. Results In 65 e-CHB group, 7（10.8%） developed LC, 4（6.2%） developed HCC and 8（12.3%） died and the cumulative survival rates were 95.4%, 90.4% and 86.7% in 5,10,15 years, respectively. In 118 e＋ CHBgroup, 15（12. 7%） developed LC, 8（6.8%） developed HCC and 12（10.2%） died and the cumulative survival rates were 97.5%, 92.8% and 84.0% in 5,10,15 years, respectively. The rate of LC and HCC and death were not markedly different （P 〉 0.05） between the two groups. Conclusion The long-term outcomes of e-CHB is not markedly different compared with that of e＋CHB.