乙型肝炎病毒B、C基因与临床关系的探讨

目的]探讨HBV基因型与肝脏组织学及其临床的关系。方法]对在福州市传染病院就诊的114例慢性乙肝患者进行肝活检及病理组织学检查,乙肝"两对半"、HBV-DNA、ALT和AST检测,对其中的74例进行血清基因型检测。结果]74例患者分别为B、C基因型(分别为38例与36例)。两组基因型比较:①在炎症分期及纤维化分级上差异无显著性;②在肝组织各部位纤维化程度的比较中,仅小叶内纤维化程度比较差异有显著性;③临床和病理诊断符合率类似;④HBV-DNA两型间差异有显著性;⑤ALT与AST两型间差异无显著性;⑥B与C型HBeAg阳性率类似。结论]慢性乙肝B、C基因型的HBV-DNA差异有显著性,而肝脏组织学改变、ALT、AST和HBeAg的差异无显著性。

Discussions on B, C Genotypes of Hepatitis B Virus and their Clinical Relationships

Objective] To explore B,C genotypes of HBV,liver histology and their clinical relationship.Methods] Liver biopsy,histopathologic examination,HbsAg,HbsAb,HbeAg,HBeAb,HBcAb,HBV-DNA,ALT and AST of 114 patients were performed in Fuzhou infectious disease hospital,and serum genotype detection was carried out for 74 of them.Results] 74 patients were detected as B(38) and C(36) genotypes respectively.Comparing with B and C genotype,significance test: 1.No significance for inflammation grade and fibrosis stage;2.Comparing with the grades of fibrosis in all parts of liver,significance was for fibrosis in liver lobules only.3.The agreement rate was similar for clinical and histological diagnosis.4.Significance was for HBV-DNA.5.No significance was for ALT and AST levels.6.No significance for HBeAg positive rate.Conclusion] There was no significant difference in the change of liver histology,ALT,AST and HBeAg,but significant difference for HBV-DNA between B and C genotype.