HBeAg血清转换延迟患者的临床病理特征

Clinical status and hepatic pathology of chronic hepatitis B virus infection with delayed HBeAg seroconverson

目的探讨HBV感染者延迟HBeAg血清转换与肝脏病理变化的相关性。方法分析148例慢性HBV感染者的血清HBeAg表达与肝脏病理改变和HBcAg的关系。结果本组病例中HBeAg阳性78例,肝脏病理炎症分级G≥2者,53例(67.9%),肝脏病理纤维化分期S≥2者,29例(37.2%),HBeAg阴性70例,G≥2者,36例(51.4%),S≥2者,25例(35.7%),HBeAg阳性与阴性组肝脏炎症损害差异有统计学意义,χ2=4.20,P<0.05,纤维化程度差异无统计学意义,χ2=0.532,P>0.05。HBeAg阳性组肝脏HBcAg阳性者有60例(76.9%)明显高于HBeAg阴性组26例(37.1%),χ2=23.98,P<0.01。两组均以胞浆型为主分别为58.3%,65.4%。结论免疫活动期,HBV感染者延迟HBeAg血清转换组与HBeAg阴性组比较有更明显的炎症程度,血清HBeAg表达与肝脏HBcAg表达有明显相关性。

Objective To explore the relationship of delayed HBeAg seroco nverson and the hepatic pathology in the patients with chronic hepatitis B.Methods A total 148 chronic HBV patients were involved in this study.To analysis the correlation between serum HBeAg,hepatic pathology and hepatocytic expression of HBcAg.Results In this study,Among 78 cases of the HBeAg positive chronic HBV patients.67.9%had equal to or more than two grade inflammation in liver（G≥2）,37.2%had equal to or more than two stage fibrosis（S≥2）.Among 70 cases of the HBeAg negative chronic HBV patients.51.4%had equal to or more than two grade inflammation in liver（G≥2）,35.7%had equal to or more than two stage fibrosis（S≥2）.The grades of liver inflammation between the the HBeAg positive and negative chronic HBV patients had statistically significant（χ2=4.20,P0.05）.But the stages of liver fibrosis had not（χ2=0.532,P0.05）.Patients with serum HBeAg positive had a higher positivity（76.9%） of HBcAg in liver tissues as compared with those with HBeAg negative（37.1%）,χ2=23.98,P0.01.Among the patients,58.3% with cytoplasmis HBcAg in HBeAg positive group,65.4% in HBeAg negative group.Conclusion In immuneactive stage,the inflammation grade in liver tisses of patients with serum HBeAg positive were obviously higher than those of HBeAg negative.there were obviously correlation between the expression of HBeAg and the experssion of HBcAg of liver tissue.