1829例HBeAg阳性慢性乙型肝炎的临床特点分析

Clinical Characteristics of 1829 Cases of HBeAg Positive Chronic Hepatitis B

目的通过大样本回顾性调查,比较HBeAg阴性与HBeAg阳性慢性乙型肝炎患者临床特点的异同.方法对1829例慢性乙型肝炎患者的住院病历进行回顾性调查,分析HBeAg阴性与HBeAg阳性慢性乙型肝炎患者年龄、肝功能、HBVDNA定量、HBV-DNA前C区变异、肝组织病理炎症及纤维化分级、临床诊断及预后等指标的差异.结果HBeAg阴性组的平均年龄较大;HBeAg阳性组和HBeAg阴性组入院时肝功能各项指标均有差异,HBeAg阴性组的TB升高和ALB降低更明显一些.HBeAg阳性HBVDNA阳性率高于HBeAg阴性组.HBeAg阴性组HBV-DNA前C区变异阳性率明显高于HBeAg阳性组.HBeAg阴性组的肝硬化、肝衰竭和肝癌的构成比明显均高于HBeAg阳性组;HBeAg阴性组的病死率也高于HBeAg阳性组.结论HBeAg阴性慢性乙型肝炎患者年龄较大、病程较长,HBV-DNA前C区变异发生率高,HBVDNA复制水平低,易发展为肝硬化、肝衰竭和肝癌.

Objective chronic hepatitis B （CHB）. To investigate the clinical characteristics of HBeAg negative and HBeAg positive Methods A total of 1 829 cases of HBeAg negative and 695 cases of HBeAg positive hospitalized CHB were analyzed retrospectively. The ages, liver function, HBV DNA levels, serum HBV DNA pre-c mutation, hepatic inflammation grading and fibrosis staging, diagnosis and prognosis were analyzed by their serum HBeAg status. Results Compared with HBeAg positive group, HBeAg negative group had a elder average ages, a higher admission serum TBil, a lower admission serum ALB, a lower HBV DNA levels and a higher serum HBV DNA pre-c mutation rate. And HBeAg negative group still had a higher constituent ratio of hepatocirrhosis, liver failure, hepatocellular carcinoma （hcc） and a higher mortality. Conclusions Compared with HBeAg positive group, HBeAg negative CHB patients have a longer course of disease, a higher serum HBV DNA pre-c mutation rate and a lower HBV replication. And Those with HBeAg negative CHB have poor prognosis and would be more likely to develop into hepatocirrhosis, liver failure, and hepatocellular carcinoma.