HBV DNA不同载量的CHB患者的HBeAg和ALT水平比较

Comparison of HBeAg and ALT levels among CHB patients with different HBV DNA loads

目的探讨乙型肝炎病毒(HBV)DNA不同载量的慢性乙型肝炎(CHB)患者乙肝病毒e抗原(HBeAg)与丙氨酸氨基转移酶(ALT)的关系,为临床治疗提供依据。方法分别比较214例ALT正常的CHB患者中HBeAg(+)、HBeAg(-)患者与200名HBsAg(-)、ALT正常的健康对照者ALT水平的差异。将ALT水平正常的214例CHB患者HBV DNA载量按HBV DNA载量分为3组(Ⅰ组:HBV DNA<103 IU/mL;Ⅱ组:103 IU/mL≤HBV DNA<104 IU/mL;Ⅲ组:HBV DNA≥104 IU/mL)。比较各组间ALT水平和HBeAg阳性率。结果 214例ALT正常的CHB患者中HBeAg(+)组及HBeAg(-)组ALT水平均高于正常对照组(P<0.01),且HBeAg(+)组ALT水平明显高于HBeAg(-)组(P<0.05);Ⅰ组CHB患者HBeAg阳性率明显低于Ⅱ组和Ⅲ组(P<0.05),Ⅲ组CHB患者的ALT水平明显高于Ⅰ组和Ⅱ组(P<0.05)。结论 HBV DNA≥104 IU/mL且ALT水平正常的CHB患者其ALT水平处于正常范围的上限,HBeAg阳性率较高,提示临床应予以更多的关注。

Objective To investigate the relationship between hepatitis B e antigen（HBeAg） and alanine aminotransferase（ALT） levels among chronic hepatitis B（CHB） patients with different loads of hepatitis B virus（HBV） DNA,and to provide the reference for clinical treatment.Methods A total of 214 CHB patients with ALT within normal range and 200 healthy subjects with HBsAg-negtive and normal ALT levels were enrolled.The ALT levels′ differences were compared among HBeAg（＋） group of CHB patients,HBeAg（-） group of CHB patients and healthy subjects.The 214 cases of CHB patients with normal ALT levels were classified into 3 groups according to HBV DNA load（GroupⅠ： HBV DNA103 IU/mL,Group Ⅱ：103 IU/mL≤HBV DNA104 IU/mL and Group Ⅲ： HBV DNA≥104 IU/mL）.ALT levels and the positive rate of HBeAg of these groups were analyzed.Results Among the 214 CHB patients,the ALT levels of HBeAg（＋） group and HBeAg（-） group were higher than that of the healthy group（P0.01）,and the ALT levels of HBeAg（＋） group were higher than those of HBeAg（-） group（P0.05）.The positive rate of HBeAg of Group Ⅰwas significantly lower than those of Group Ⅱ and Group Ⅲ（P0.05）.The ALT levels of Group Ⅲ were significantly higher than those of Group Ⅰ and Group Ⅱ（P0.05）.Conclusions The ALT level is at the upper limit of normal range,and the positive rate of HBeAg is rather high in CHB patients with ALT within the normal range and HBV DNA≥104 IU/mL,which suggests that more attention should be paid for the patients in the clinical course of treatment.