慢性乙型肝炎血清HBV DNA载量与肝组织病理的关系

目的探讨HBeAg阳性和HBeAg阴性慢性乙型肝炎血清HBV DNA载量与肝组织炎症活动度、纤维化程度之间的关系。方法分别对103例HBeAg阳性和81例HBeAg阴性慢性乙型肝炎患者肝脏穿刺活检,进行肝组织炎症活动度分级和纤维化程度分期,同期检测血清HBV DNA载量,并分析两者之间的关系。结果 103例HBeAg阳性慢性乙型肝炎患者血清HBV DNA载量与肝组织炎症活动度、纤维化程度均无明显相关性(r=0.125,P>0.05;r=0.164,P>0.05)。81例HBeAg阴性慢性乙型肝炎患者血清HBV DNA载量与肝组织炎症活动度、纤维化程度均呈正相关(r=0.326,P<0.01;r=0.267,P<0.05)。结论 HBeAg阴性慢性乙型肝炎患者血清HBV DNA载量能反映肝组织炎症活动度和纤维化程度,可作为抗病毒药物选择和疗效观察的指标。

Relationship of serum HBV DNA levels and pathological changes of liver tissue in patients with chronic hepatitis B

Objective To determine the relationship between serum HBV DNA levels and the inflammation activity and fibrosis of the liver tissues in the patients with HBeAg-positive and HBeAg negative chronic hepatitis B. Methods Serum HBV DNA was assayed in 103 patients with HBeAg-positive and 81 patients with HBeAg-negative chronic hepatitis B. Liver biopsy was conducted simultaneously to determine the inflammation grade and fibrosis stage of the liver tissues. Results There were correlation between the inflammation activity and fibrosis of liver tissue and the serum HBV DNA levels in 81 patients with HBeAg-negative chronic hepatitis B （r=0.326, P〈0.01; r=0.267, P〈0.05）, hut no correlation in 103 patients with HBeAg-positive chronic hepatitis B （r=0. 125, P〉0.05; r=0. 164, P〉0.05）. Conclusion Serum HBV DNA level can re- flect the liver inflammation activity and fibrosis in the patients with HBeAg-negative chronic hepatitis B, which may be the indi cator for choosing anti-virus therapy and evaluating effects on HBV replication.