468例CHB患者肝纤维化进展与血清病毒学指标演变关联性探讨

Study of the correlation between the progress of liver fibrosis and evolution of serum virology indicators in 468 patients with chronic hepatitis B

目的探讨慢性乙型病毒性肝炎(CHB)患者肝纤维化进展与血清病毒学标志的演变关系。方法选择468例CHB患者,根据其不同的肝纤维化程度由轻及重(S0-1,S2,S3-4)分为三组,分别统计三组患者肝纤维化分级与HBe Ag状态及HBV DNA载量的关系。结果随着肝纤维化进展(S0-S1→S2→S3-S4),HBe Ag阳性者的比例逐渐下降(60.00%>23.25%>16.75%),HBe Ag阴性的比例逐渐升高(23.53%<33.82%<42.65%),其差异有统计学意义(χ2=35.756,P<0.001);不同血清HBV DNA载量的患者,肝纤维化水平不同(χ2=58.790,P<0.001),随着肝纤维化的进展,血清HBV DNA呈逐渐下降趋势(r=-0.343)。HBe Ag阳性CHB患者中,其肝纤维化进展与HBV DNA载量的差异同样具有统计学意义(χ2=38.011,P<0.001),肝纤维化水平与HBV DNA载量亦呈负相关(r=-0.290)。结论慢性乙型病毒性肝炎患者随着肝纤维化进展(S0-S1→S2→S3-S4),其血清HBe Ag阳性的比例与HBV DNA载量均呈逐渐下降的趋势,其中HBe Ag持续阳性患者的HBV DNA载量随肝纤维化进展表现出相似的特点。

Objective To investigate the correlation between the progress of liver ifbrosis and evolution of serum virology indicators.Methods Total of 468 patients with chronic hepatitis B were included in our study. Three groups （S0-1, S2, S3-4） were divided according to the liver ifbrosis stages and the relationship between liver ifbrosis stages and expression levels of HBeAg as well as HBV DNA levels were analyzed respectively.Results With the progress of liver fibrosis （S0-S1→S2→S3-S4）, the positive proportion of HBeAg was gradually decreased （60.00%〉 23.25%〉 16.75%）. Contrarily, the negative percentage of HBeAg presented with an increased trend （23.53%〈 33.82%〈 42.65%） and the differences were of statistical significant （χ2= 35.756,P〈0.001）. HBV DNA levels were different among patients with different stages of liver ifbrosis （χ2= 58.790,P〈0.001）. With the progress of liver ifbrosis, HBV DNA levels showed a declined trend （r = -0.343）. Differences between liver ifbrosis stages and HBV DNA copies in CHB patients with positive expression of HBeAg were also of statistical signiifcant （χ2= 38.011,P〈0.001）. In addition, HBV DNA levels and liver ifbrosis stages were also presented with a negative correlation （r = 0.290）.Conclusions With the progress of liver ifbrosis （S0-S1→S2→S3-S4）, positive proportions of HBeAg and HBV DNA levels both manifested a gradually declined trend. Similarly characteristics were detected in CHB patients with persistently positive expression of HBeAg.