经相同肝实质细胞体积分摊的血清HBsAg水平与肝组织病理进展相关而与HBeAg状态无关

HBsAg Levels Normalized to the Same Hepatic Parenchyma Cell Volume Is Correlated with Pathological Progression but Not HBeAg Status

【目的】回顾性研究HBeAg阳性与HBeAg阴性慢性乙型病毒性肝炎之间,血清HBsAg的水平以及经相同肝实质细胞体积(肝细胞数量)分摊计算后血清HBsAg水平的异同。【方法】选取中山大学附属第三医院168例因病情需要而进行了肝穿刺活检及HBsAg定量检测的慢乙肝患者为研究对象。比较其HBeAg阳性与HBeAg阴性之间的血清HBsAg水平,以及经相同肝实质细胞体积(肝细胞数量)分摊计算后的血清HBsAg水平。【结果】血清HBsAg水平在HBeAg阳性和HBeAg阴性慢乙肝患者之间的差异有统计学意义(P=0.028);而经相同肝实质细胞体积(肝细胞数量)分摊计算后的血清HBsAg水平,在HBeAg阳性和HBeAg阴性慢乙肝之间的差异无统计学意义(P=0.073)。无论HBeAg阳性或HBeAg阴性,其血清HBsAg水平的高低与肝组织炎症程度无相关性(HBeAg阳性:rs=0.020,P=0.876;HBeAg阴性:rs=0.037,P=0.711);与肝纤维化进展无相关性(HBeAg阳性:rs=0.087,P=0.488;HBeAg阴性:rs=0.144,P=0.148)。而经相同肝实质细胞体积(肝细胞数量)分摊计算后的血清HBsAg水平与肝组织炎症程度呈正相关(HBeAg阳性:rs=0.309,P=0.012;HBeAg阴性:rs=0.389,P<0.001);与肝纤维化进展呈正相关性(HBeAg阳性:rs=0.490,P<0.001;HBeAg阴性:rs=0.599,P<0.001)。【结论】经相同肝实质细胞体积(肝细胞数量)分摊计算后的血清HBsAg,而非血清HBsAg水平,在HBeAg阳性或HBeAg阴性慢乙肝之间无差异;且均与肝组织炎症分级和纤维化分期程度呈正相关。

【Objective】To study retrospectively the serum hepatitis B surface antigen(HBsAg)and HBsAg normalized to the same hepatic parenchyma cell volume(HPCV),namely ,the same hepatic cell quantities,between HBeAg positive and HBeAg-negative chronic hepatitis B(CHB).【Methods】A total of 168 CHB patients who had undergone liver biopsy and test of serum HBsAg levels due to their disease in the Third Affiliated Hospital of SunYat-sen University were selected as the study subjects. The serum HBsAg levels,as well as HBsAg levels normalized to HPCV(hepatic cell quantities)were compared between HBeAg-positive and HBeAg- negative CHB,respectively.【Results】There was statistically significant difference in serum HBsAg levels between HBeAg-positive and HBeAg-negative CHB(P = 0.028), while there was no statistical difference in HBsAg normalized to HPCV(P = 0.073). There were no correlations between serum HBsAg and liver inflammation grades(HBeAg-positive:rs = 0.020,P = 0.876 & HBeAg-negative:rs = 0.037,P =0.711). Similarly,there were no correlations between HBsAg and hepatic fibrosis stages(HBeAg-positive:rs = 0.087, P = 0.488 & HBeAg-negative:rs = 0.144,P = 0.148). Nevertheless,statistically significant positive correlations were shown between HBsAg normalized to HPCV and liver inflammation grades(HBeAg-positive:rs = 0.309,P = 0.012 & HBeAg-negative:rs = 0.389,P < 0.001). Similarly,the HBsAg normalized to HPCV and hepatic fibrosis stages were shown to be statistically significantly correlated(HBeAg- positive:rs = 0.490,P < 0.001 & HBeAg-negative:rs = 0.599, P < 0.001).【Conclusions】Serum HBsAg normalized to HPCV but not HBsAg levels,is correlated with liver inflammation grades as well as hepatic fibrosis stages positively in both HBeAg-positive and HBeAg-negative CHB. But there is no difference in serum HBsAg levels normalized to HPCV between HBeAg-positive and HBeAg-negative CHB.