慢性乙型肝炎e抗原阳性及阴性患者临床特点分析

An analysis of clinical features in HBeAg-negative and HBeAg-positive chronic hepatitis B

目的分析HBeAg阴性及阳性CHB患者-临床及病毒学特点。方法对209例CHB患者的临床资料、肝功能和HBVDIqA进行分析。结果209例CHB患者中男143例，女66例。HBeAg阴性患者121例，占57．9％（121／209），平均年龄（42．9±10．7）岁，病程（16．7±8．2）年。HBeAg阳性患者88例，占42．1％（88／209），平均年龄（37．1±11．3）岁，病程（12．2±8．3）年。HBeAg阴性患者平均年龄及病程均高于HBeAg阳性患者，差异有统计学意义（t值分别为-6．21和-5．42，P值均〈0．01）。HBeAg阴性及阳性患者ALT分别为（37．6±32．8）o／L和（82．2土107．5）U／L，差异有统计学意义（t=5．31，P〈0．01），两组患者的ALT分布差异也有统计学意义（X^2=40．20，P〈0．01）。HBVDNA大于105拷贝／ml的患者，HBeAg阴性组46例，占38．0％（46／121），HBeAg阳性组83例，占94．3％（83／88），HBeAg阴性组低于阳性组（X^2=180．32，P〈0．01）。结论应重视对HBV DNA低复制的HBeAg阴性的CHB患者的随访和治疗。

Objective To analyze the frequency and the clinical HBeAg-negative and HBeAg-positive Chronic hepatitis B.Methods and virological features of Two hundred and nine chronic hepatitis B patients, 143 males and 66 females seen in our center were studied. Results The cases with HBeAg-negative chronic hepatitis B were 121（57.9%）,with an average age of （42.9 ± 10.7） and a history of （16.7 ± 8.2） years. HBeAg positive chronic hepatitis B cases were 88 （42.1%）, with an average age of （37. 1±11.3） and a history of （12.2±8.3） years. HBeAg-negative patients were significantly older（P〈0.01） in age and had a longer disease history. ALT levels and the percentage of HBV DNA were higher than 105copies/ml in HBeAg-negative patients and were significantly lower than those in the HBeAg-positive patients（37.64±32.83）U/L vs. （82.18±107.62）U/L, 38.0%vs. 94.3%, P〈0.01）.Conclusion Despite lower serum ALT and HBV DNA, HBeAg-negative chronic hepatitis B still has a significant disease progression. This observation may help to develop better clinical management in HBeAg-negative chronic hepatitis B patients.