高复制型慢性乙型肝炎患者肝内HBV复制指标与肝脏病变的关系

33例均为HBsAg、HBeAg及抗HBc三项阳性(部分伴HBcAg、DNA P或HBV DNA阳性)。病理报告慢性小叶性肝炎6例,慢性持续性肝炎27例.应用Southern Blot法共查肝内HBV DNA25例,其中阳性13例(52％),包括游离型9例,游离十整合型2例,整合型2例,应用双桥PAP法共查HBsAg及HBcAg23例,其中HBsAg阳性15例(65.2％),HBcAg阳性11例(43.8％)。提示肝内HBV DNA及HBcAg阳性组各项旰脏病变检出率在50％以上,项目(7项)比阴性组(5项)为高,并与血中DNAP、HBV DNA复制指标及ALT异常率相一致,肝内HBV DNA游离型及游离十整合型各项肝脏病变检出率也比整合型为高。因而,慢乙肝肝脏病变持续存在,与乙肝病毒复制有关,抗病毒治疗应予重视。

Correlation between Changes of Indexes Representing Duplication of HBV and Hepato-pathologic Findings in Patients with High Duplicate Chronic Hepatitis B

The 33 cases were HBsAg, HBeAg and anti-HBc positive, some accompartied with HBcAg, DNAP or HBV DNA positive. The pathological report was: chronic lobular hepatitis(CLH)6 eases, chronic persistent hepatitis (CPH) 27 cases. With Southern Blottest, it. examined HBV DNA 25 cases in liver. Of them, 13 cases were positive (52.0%). It included free type 9 cases, freereorganization type 2cases, and reorganization type 2 cases. With double bridge PAP test, it examined HBsAg and HBcAg 23 cases. Of them, HBsAg and HBcAg positive was 15 cases (65.2%)and 11 cases (43.8%) respectively Relationship observation had made among various hepatic pathological changes and HBV repalication marks in liver and setum, liver function and various type of HBVDNA in liver. It showed that not only the number(7 item)of the examined rate of various hepatic pathological changes over 50% in the positive group of HBV DNA and HBcAg in liver was higher to negative group(5 item), but also the agreement existed with the serum DNAP and HBV DNA replication marks and the abnormal rate of ALT. The number of the examined rate of various hepatic pathological changes in the free and freereorganization type of HBV DNA in liver was also higher to reorganization type. It showed that the hepatic pathological changes of chronic hepatitis B persistent exsist was not only because of immune damage, but also related to the HBV replication. Thus, the antiviral treatment in the chronic hepatitis B is important. It must be noticed.