慢性乙型肝炎病毒感染免疫耐受期患者的临床病理特征

目的:了解HBV慢性感染免疫耐受期患者的临床及病理学特征．方法:分析HBV感染不同时期380例患者的年龄、母婴垂直传播感染途径、乙肝家族史、肝细胞内HBsAg、HBcAg表达状况及肝组织病理学特征．结果:HBV慢性感染免疫耐受期患者年龄 16岁以下占61．8％,母婴垂直传播感染者占 55．0％,有乙肝家族史患者占46．6％,免疫耐受期患者89例肝组织内HBcAg阳性表达率 78．7％,均明显高于免疫活动期及感染非活动状态患者(x2=38．73,49．08,17．2,31．69, P<0．01)．免疫耐受期16岁以下的患者肝组织内HBsAg及HBcAg阳性表达率最高,分别占64．3％(45／75)和72．9％(51／79),显著高于免疫活动期和非活动HBV携带状态患者(x2= 17．51,31．17,P<0．001)．免疫耐受期16岁以上的患者肝组织内HBsAg及HBcAg阳性表达率最低,分别占35．7％(25／75)和27．1％(19／70),显著低于免疫活动期和非活动HBV携带状态患者(x2=17．51,x2=31．17,P<0．001)．结论:HBV慢性感染免疫耐受期患者中16岁以下者,母婴垂直传播感染者及乙肝家族史者所占比例明显高;HBV在肝组织复制表达以免疫耐受期患者最多,且16岁以下的患者占多数．

Clinical status and hepatic pathology of patients with chronic hepatitis B virus infection in immune tolerant phase

AIM: To investigate the characteristics of the clinical status and hepatic pathology of patients with hepatitis B virus (HBV) infection in immune tolerant phase. METHODS: Three hundred and eighty patients with chronic HBV infection of different phases were involved in this study. The data about the ages of patients, vertival transmission, family history of HBV infechon, hepatocytic expression of HBsAg and HBCAg and hepatic pathology were statistically analyzed. RESULTS: It was found that 61.8% of patients in immune tolerant stage were less than 16 years old, and 46.6% with a family history of HBV infection. Vertival transmission covered a percentage of 55% and in patients of immune tolerant stage. Of 89 patients in immune tolerant stage, the ratio of HBcAg expression was 78.7%. The ratios above were significantly higher than the corresponding ones in patients of immune active stage or non-active status (x2 = 38.73, 49.08, 17.2, 31.69, respectively, all P < 0.01). For the patients less than 16 years old, the ratios of hepa-tocytic expression of HBSAg and HBCAg were 64.3% (45/75) and 72.9% (51/79), respectively, in immune tolerant stage which were obviously higher than those in immune active stage or non-active status (x2=17.51,31.17, both P < 0.001). For the patients more than 16 years old, the ratios of hepatocytic HBSAg and HBCAg expression were 35.7% (25/75) and 27.1% (19/70), respectively, in immune tolerant stage, which were markedly lower than those in immune active stage or non-active status (x2=17.51, x2 = 31.17, both P < 0.001). CONCLUSION: Vertival transmission and family history of HBV infection have higher proportions in chronic HBV infection patients less than 16 years old in immune tolerant stage. HBV replicates most in patients of immune tolerant stage, especially in those less than 16 years old.