e抗原阴性慢性乙型肝炎临床病理相关性分析

Clinical pathology character analysis of HBeAg-negative chronic hepatitis B

目的了解HBeAg阴性慢性乙型肝炎临床和病理表现的相互关系。方法对154例HBeAg阴性慢性乙型肝炎患者进行血生化、病毒标志物及病毒定量检测,与肝组织病理进行相关性分析。结果病理诊断中、重度患者数量多于临床分度数量(80例对37例),白蛋白/球蛋白和凝血酶原活动度(PTA)对重度肝炎诊断有一定的临床价值.HBV DNA水平和抗-HBe是否阳性与肝脏损害程度无关,血清透明质酸水平与肝纤维化程度相关(X^2=6.937 6,P=0.039)。结论HBeAg阴性慢性乙型肝炎患者应尽可能行肝脏病理检查以明确诊断,并指导治疗。

Objective To analyse the clinical and pathologic characters of HBeAg-negative chronic hepatitis B patients. Methods 154 HBeAg-negative chronic hepatitis B patients were selected, liver function test, virus marker and virus loading were observed, correlation analysis was performed with pathological grading. Results The patient＇s number diagnosed by pathology from moderate to severe hepatitis is higher than that diagnosed by clinical manifestation （80 vs 37）. It is valuable clinically to diagnose severe hepatitis with albumin/globulin and prothrombin activity（PTA）. Serum HBV DNA level and anti-HBe status cann＇t reflect grading of liver inflammation, but hyaluronic acid level is correlated with liver fibrosis （χ^2 = 6. 937 6,P = 0. 039）. Conclusion Liver biopsy and pathologic examination should be carried out in HBeAg-negative chronic hepatitis B patients.