乙型肝炎HbeAg阳性与阴性患者肝功能及血清纤维化指标比较

The Comparison of Liver Function and Serum Fibrosis Markers between HbeAg Positive and Negative Patients with Hepatitis B

目的探讨乙型肝炎(乙肝)HbeAg阳性和HbeAg阴性两种病毒携带状态肝功能与血清纤维化指标的差异。方法选择我院2010年1～12月收治的慢性乙肝患者232例,按HbeAg阳性与HbeAg阴性分组,两组均行血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、乙肝病毒DNA(HBV-DNA)、血清透明质酸(HA)、Ⅳ型胶原(Ⅳ-C)检测,分析各指标与慢性肝病的相关性。结果 HbeAg阳性组ALT、HBV-DNA分别为(429.10±178.49)U/L、(4.41±0.87)×104copy/ml,HbeAg阴性组分别为(205.10±85.55)U/L、(2.38±1.71)×104copy/ml,两组比较差异有统计学意义(P<0.01);HbeAg阳性组AST、HA及Ⅳ-C分别为(98.00±4.36)U/L、(145.00±32.65)μg/L、(327.80±60.43)μg/L,HbeAg阴性组分别为(96.58±5.38)U/L、(135.00±23.75)μg/L、(321.30±35.09)μg/L,两组比较差异无统计学意义(P>0.05)。结论 HbeAg阳性患者病毒复制活跃,但HbeAg阳性及HbeAg阴性患者均存在一定程度的肝损害及肝纤维化,故HbeAg阴性患者仍需定期检查,控制疾病进展,以降低肝硬化的发病率。

Objective To investigate the difference of liver function and serum fibrosis markers between HbeAg positive and negative patients with hepatitis B.Methods 232 cases of hepatitis B were enrolled from January 2010 to December 2010,and were divided into HbeAg positive group and HbeAg negative group.The level of serum alanine aminotransferase（ALT）,aspartate aminotransferase（AST）,HBV-DNA,HA,and IV collagen（IV-C） were detected,and the relationship between the indicators and chronic liver disease was analyzed.Results ALT and HBV-DNA in HbeAg positive group were（429.10±178.49）U/L,（4.41±0.87）×104 copy/ml,but（205.10±85.55）U/L,（2.38±1.71）×104 copy/ml in HbeAg-negative group,there was significant difference between the two groups（P0.01）;AST,HA and IV-C in HbeAg positive group were（98.00±4.36）U/L,（145.00±32.65）μg/L,（327.80±60.43）μg/L respectively,but in HbeAg-negative group they were（96.58±5.38）U/L,（135.00±23.75）μg/L,（321.30±35.09）μg/L,and there was no significant difference between the two groups（P0.05）.Conclusion Virus replicates actively in HbeAg positive patients,but both HbeAg positive and negative patients have a certain degree of liver damage and fibrosis.It is necessary to take regular checks for HbeAg-negative patients to control disease progression and to reduce the incidence of hepatic cirrhosis.