HBeAg阴性和阳性慢性乙型肝炎病人肝脏组织学变化

HISTOLOGICAL CHANGES OF HEPATIC TISSUES IN PATIENTS WITH HBeAg POSITIVE AND NEGATIVE CHRONIC HEPATITIS B

目的比较HBeAg阴性和阳性慢性乙型肝炎病人肝脏组织学变化情况。方法对266例行肝活检的慢性乙型肝炎病人行免疫组化检测肝组织HBsAg、HBcAg的变化；采用双抗体夹心酶联免疫法检测血清前S1蛋白、HBV—DNA、HBsAg等的变化。按肝组织炎症、纤维化程度分组，比较HBeAg阳性和阴性的分布，并比较肝组织中HBsAg、HBcAg在HBeAg阳性和阴性组的阳性率。结果HBeAg阳性和阴性组肝组织炎症程度分布比较差异有显著性（Uc=2．716，P〈0．01）。HBeAg阳性和阴性组肝组织纤维化程度分布比较差异无显著性（Uc=1．493，P〉0．05）。HBeAg阳性组血清前S。蛋白、HBV—DNA及肝组织中的HBsAg、HBcAg的阳性率明显高于HBeAg阴性组，差异有极显著性（χ^2=8．47～41．29，P〈0．01）。结论HBeAg阳性组肝组织炎症程度高于阴性组。HBeAg阳性组血清前s。蛋白、HBV—DNA及肝组织中的HBsAg、HBcAg等病毒复制指标的阳性率明显高于HBeAg阴性组。

Objective To compare the histological changes of hepatic tissues of patients with HBeAg positive or HBeAg negative chronic hepatitis B. Methods Hepatic tissue samples from 266 patients with chronic hepatitis B were detected for the presence of HBsAg and HBcAg with Immunohistochemistry technique. Serum levels of pre S1 protein, HBV DNA, and HBsAg were tested by using double antibody ELISA. The patients were divided into groups according to the degree of tissue inflammation and fibrosis. The distribution of HBeAg and the positive rates of HBsAg and HBcAg in liver tissue were compared among different groups. Results There was a significant difference in the intensity of inflammation between HbeAg positive and negative groups （Uc= 2.716, P〈0.01）. The difference in the degree of liver fibrosis between the two groups was not significant （Uc= 1. 493, P〉 0.05）. The serum levels of pro-S1 protein and HBV DNA, and the positive rates of HBsAg and HBcAg in liver tissue were significantly higher in HBeAg positive group than that in HBeAg negative （χ^2=8.47-41.29,P〈0.01）. Conclusion The degree of inflammation and fibrosis of the liver tissue was higher in HBeAg positive group than that in HBeAg negative. The serum levels of pro-S1 protein and HBV-DNA, and the positive rate of virus replication markers such as HBsAg and HBcAg in patients with HBeAg positive hepatitis B were higher than that in patients with HBeAg negative hepatitis B.