乙肝后肝硬化失代偿期HBeAg阴性与阳性患者 病毒学特点及肝功能指标的比较

摘要:目的　分析乙型肝炎后肝硬化失代偿期患者中HBeAg阴性者与HBeAg阳性者的血清病毒学指标、肝功能检测结果的差异。方法　将90例乙肝后肝硬化失代偿患者分为HBeAg阴性组和HBeAg阳性组，观察年龄、性别、乙肝病毒基因型、血清病毒DNA载量、肝功能指标等的差异。结果　HBeAg阴性组和HBeAg阳性组比较，年龄、性别、肝功能指标、Child-Pugh分级均无差异；HBeAg阴性组血清乙肝病毒DNA载量（5.14±0.63）log 10copies/ml 低于HBeAg阳性组（6.66±0.75）log10copies/ml，（t＝10.386，P＜0.001）；两组乙肝病毒基因型的比较差异有统计学意义，HBeAg阴性组基因型B占26.2%（11/42），基因型C占54.8%（23/42），B/C混合型占19.0%（8/42），HBeAg阳性组基因型B占12.5%（6/48），基因型C占87.5%（42/48），（χ2＝14.580，P＜0.001）。结论　HBeAg阴性与阳性乙型肝炎后肝硬化失代偿期患者在乙肝病毒基因型构成特点、病毒DNA载量上有差异，两组肝功能受损程度没有显著差异。

Comparison of virological feature and liver function between patients with HBeAg-negative and HBeAg-positive hepatitis B-related decompensated cirrhosis

Abstract: Objective To analyze the difference of virological features and liver functions between patients with HBeAg negative and HBeAg positive hepatitis B-related decompensated cirrhosis. Methods 90 patients with hepatitis B-related decompensated cirrhosis were divided into two groups: group HBeAg positive and group HBeAg negative. We studied the differences among their age, sex, HBV genotype, serum HBV DNA load, liver function index, etc. Results No significant differences in age, sex, levels of liver functions and Child-Pugh scores were found between the HBeAg positive and HBeAg negative. The serum HBV DNA loads were higher in group HBeAg positive (6.66±0.75) log 10copies/ml than in group HBeAg negative (5.14±0.63) log 10copies/ml (t=10.386, P<0.001). Genotype distribution also showed significant differences in group HBeAg positive and group HBeAg negative (χ2=14.580, P<0.001). In group HBeAg negative genotype C accounts for 54.8% (23/42), genotype B accounts for 26.2% (11/42), genotype B/C accounts for 19.0% (8/42). In group HBeAg positive genotype C accounts for 87.5% (42/48), genotype B accounts for 12.5% (6/48). Conclusion There were significant differences in genotype distribution and the level of HBV DNA in serum between patients with HBeAg negative and HBeAg positive hepatitis B-related decompensated cirrhosis. There was no significant difference in liver functions between the two groups.