慢性HBV感染者血清HBeAg及HBV DNA与肝组织病理分级、分期的关系

目的：观察肝功能正常的慢性乙型肝炎病毒（HBV）感染者的肝组织病理改变特征,并分析血清HBeAg及HBV DNA定量与肝组织病理改变的关系。方法：选取肝功能正常的慢性HBV感染者101例,行肝穿刺病理检查,依据血清HBeAg及HBV DNA将患者分组,分别比较HBeAg阳性和阴性组及HBV DNA阳性和阴性组患者肝组织炎症分级和纤维化分期。结果：101例肝功能正常的慢性HBV感染者,83.2%（84/101）的患者存在不同程度的病理损害,其中,轻度62例（61.40%）,中度11例（10.90%）,重度7例（6.93%）,肝硬化4例（3.96%）。HBeAg阴性组炎症分级和纤维化分级明显重于HBeAg阳性组（P〈0.05或P〈0.01）,HBV DNA阴性者肝纤维化分期明显重于HBV DNA阳性者（P〈0.01）。结论：对于慢性乙肝病毒携带者,HBeAg及HBV DNA不能很好地反映肝组织的病理改变,应尽早进行肝活检,有利于判断病情和确定治疗方案。

The relationship between serum HBeAg, HBV DNA and liver pathological change in chronic hepatitis B virus carriers

Objective：To explore the relationship between serum HBeAg,the qualification of HBV DNA and the histopathologic change of livers in chronic hepatitis B virus carriers with normal liver function.Methods：Liver biopsy,serum and serological examination were performed in 101 randomly selected chronic hepatitis B virus carriers with normal 1iver function.Groups were divided based on serum HBeAg and HBV DNA levels.Comparisons of liver inflammation and fibrosis stages were conducted between groups.Results：83.2%（84/101） subjects had liver injury,62（61.40%） slight CHB,11（10.90%） moderate CHB,and 7 （6.93%） severe CHB,4 （3.96%） cirrhosis.The inflammation and fibrosis stages in HBeAg negative group were more severe than HBeAg positive group（P0.05 or P0.01）.The fibrosis stages observed in HBV DNA negative groups were more severe than HBV DNA positive groups（P0.01）.Conclusion：HBeAg and HBV DNA are unable to reflect the real condition of liver injury for the chronic HBV carriers.Therefore,hepatic pathological examination should be recommended in the chronic HBV carriers,which contributes to the understanding of disease state and selection of treatment regimen.