189例e抗原阴性慢性乙型肝炎肝组织学与血清学指标的关系探讨

目的探讨HBeAg阴性慢性乙型肝炎（CHB）患者临床血清学指标和肝组织病理学的关系。方法对189例HBeAg阴性CHB患者进行肝组织病理炎症活动度、分级和纤维化分期与同期血清HBV DNA水平、血生化指标进行相关性分析。结果 189例HBeAg阴性CHB患者肝组织病理炎症活动度分级与血清HBV DNA水平相关（χ2=30.26,P〈0.01）;肝组织纤维化程度分期与血清HBV DNA水平无明显相关性（χ2=10.94,P〉0.05）。患者血清中TBIL、ALT、AST、GGT水平与肝组织炎症程度呈正相关,其ALB、PTA与之呈负相关。结论 HBeAg阴性CHB患者病毒复制活跃和血清TBIL、ALT、AST、GGT能反映肝组织炎症活动。

Study on the relationship between pathology and serum markers of HBeAg- negtive chronic hepatitis B

Objective To study the relationship between pathology and clinical serologic markers of HBeAg-negtive chronic hepatitis B（CHB） patients. Methods 189 HBeAg-negative CHB patients were select- ed, their hepatic pathology inflammation activity was classified, correlation analysis was performed with serum HBV-DNA level and blood biochemical indexes. Results Among 189 HBeAg-negative chronic hepatitis B pa- tients, hepatic pathology inflammation activity grading was correlated with serum HBV-DNA level（ X2 = 30. 26, P 〈0.01 ） ;The fibrosis stage had no significant correlation with serum HBV-DNA level（X^2 = 10. 94,P 〉0. 05）. Serum TBIL, ALT, AST, and GGT had positive correlation with hepatic pathology inflammation activity grading, but serum ALB, PTA had negative correlation with the grading. Conclusion The active HBV replication and se- rum TBIL, ALT, AST, and GGT could reflect the hepatic inflammation activity.