137例慢性乙型肝炎患者肝功能与乙型肝炎病毒DNA及乙型肝炎e抗原相关性分析

目的探讨慢性乙型肝炎患者治疗过程中血清丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）水平变化与乙型肝炎e抗原（HBeAg）和慢性乙型肝炎病毒（HBV）DNA的相关性。方法 137例血清ALT、AST水平正常的慢性乙型肝炎患者中HBeAg和HBV DNA同时阳性46例,同时阴性48例,单项HBVDNA阳性35例,单项HBeAg阳性8例。3～6个月后分别对各组患者复发前后血清HBV DNA、ALT、AST水平及ALT、AST异常水平的例数进行比较。结果复发前HBeAg和HBV DNA同时阳性组、HBV DNA阳性组、HBeAg阳性组的ALT、AST水平分别为（22.93±18.45）U/L和（24.12±15.67）U/L、（21.74±16.48）U/L和（17.87±18.05）U/L、（20.55±17.33）U/L和（19.72±16.91）U/L,复发后分别为（529.65±252.42）U/L和（434.18±218.53）U/L、（419.06±204.26）U/L和（476.63±189.43）U/L、（326.48±187.95）U/L和（347.27±198.15）U/L,差异均有统计学意义（P〈0.05）。HBeAg和HBV DNA同时阴性组ALT、AST水平复发前后差异无统计学意义（P〉0.05）。结论血清HBeAg和HBV DNA的检测对慢性乙型肝炎患者诊断、治疗、预后判断有重要的作用,提示慢性乙型肝炎治疗HBeAg的阴转和HBV DNA不能检出能维持较低的复发率。

Analysis on correlation of liver function in chronic hepatitis B with HBeAg and HBV DNA

Objective To investigate the correlation of changes of serum ALT and AST level with HBeAg and HBV DNA in the patients with chronic hepatitis during treatment process. Methods 137 patients with chronic hepa- titis and normal serum ALT and AST were divided into four groups, HBeAg and HBV DNA simultaneously positive group （46 cases）, HBeAg and HBV DNA simultaneously negative group （48 cases）, HBV DNA positive group（35 cases） and HBeAg positive group（8 cases）. The level of HBV DNA,ALT and AST, and number of abnormal ALT and AST cases after 3--6 months before and after relapse were compared among groups. Results The levels of ALT and AST before relapse were （22.93±18.45）U/L and （24.12±15.67）U/L in the HBeAg and HBV DNA simulta- neously positive group, （21.74±16.48）U/L and （17.87±18.05）U/L in the HBV DNA positive group, and （20.55 ±17.33）U/L and （19.72±16.91）U/L in the HBeAg positive group, which after relapse were （529.65±252.42） U/L and（434.18±218.53）U/L, （419.06±204.26）U/L and（476.63± 189.43）U/L,and（326.48±187.95）U/L and （347. 27±198.15）U/L respectively, showing statistical difference among them（P〈0.05）. The levels of ALT and AST before and after relapse in HBV DNA simultaneously negative group had no statistical difference. Conclusion The serum HBeAg and HBV DNA detection has important role in diagnosis, treatment and prognosis of chronic hep- atitis B. It is suggested that HBeAg negative converting and HBV DNA undetectable during treatment can maintain low recurrence rate.