HBeAg阴性慢性乙肝患者生化、HBV DNA及肝纤维化的对比分析

Comparison of biochemistry,HBV DNA and hepatic fibrosis of HbeAg negative chronic hepatitis B

目的比较HBeAg阴性与阳性慢性乙肝(CHB)患者血清肝功能、病毒载量及肝纤维化程度,分析其病毒复制与病情变化的关系,总结HBeAg阴性CHB特点。方法分别检测HBeAg阴性组和阳性组CHB肝功能指标(ALT、AST、TBIL)、HBV DNA定量、肝纤维化指标(HA、PC-Ⅲ、C-IV,LN)、凝血酶原活动度(PTA),并对两组患者的年龄、病程进行比较。结果HBeAg阴性组CHB年龄较大、病程较长,HBVDNA定量水平低,与HBeAg阳性CHB比较均有显著性差异(P<0.05);肝纤维化指标重于HBeAg阳性组CHB,且在中度组间C-IV比较有显著性差异(P<0.05);两组患者肝功能、PTA在轻、中、重度组间比较均无统计学差异(P>0.05)。结论HBeAg阴性CHB年龄较大、病程较长,HBV DNA复制水平低于HBeAg阳性CHB,随病情的加重,有逐渐减低趋势;肝纤维化指标重于HBeAg阳性CHB,更易向肝硬化发展。

Objective To compare liver function, virus load and hepatic fibrosis degree in the serum between HbeAg negative and positive CHB, investigate relationship between viral replication and liver function damage, summarize the feature of HbeAg negative CHB. Methods The liver function index （ALT, AST, TBIL）, HBV DNA quantitation, hepatic fibrosis index （HA, PC - Ⅲ, Ⅳ, LN）, plasmozyme activity （PTA） of HbeAg negative and positive CHB patients were measured. The variability between them, the age and course of two groups were compared and analyzed. Results The age and course of HbeAg negative CHB were older and longer, HBV DNA was lower than those in HbeAg positive CHB, and significant difference （ P 〈 0.05 ）. Hepatic fibrosis index of HbeAg nega- tive CHB are outweigh with HbeAg positive CHB, and Ⅳin midrange had significant difference （ P 〈 0.05）. Liver function and PTA had no significant difference in light, middle and heavy degree from two groups （ P 〉 0.05 ）. Conclusion The age and course of HbeAg negative CHB are older and longer, HBV DNA is lower than those in HbeAg positive CHB, and tends to degrade accompanied with Liver function damaging gradually. Hepatic fibrosis index of HbeAg negative CHB are outweigh with HbeAg positive CHB, easily progresses to hepatic cirrhosis.