抗病毒治疗对住院慢性乙型肝炎病毒感染者疾病谱构成比的影响

目的探讨抗病毒治疗对住院慢性乙型肝炎病毒（HBV）感染者疾病谱构成比的影响。方法对2011年在中山大学附属第三医院感染科住院的1 619例慢性HBV感染者进行回顾性调查分析,根据入院前是否有抗病毒治疗情况分为抗病毒组（n=279）和对照组（n=1 340）;根据是否按医嘱规范治疗,将279例抗病毒患者分为规范抗病毒组（n=198）及不规范抗病毒组（n=81）;再根据入院时HBV DNA水平不同（≥100IU/ml或〈100IU/ml）,将198例规范抗病毒组患者细分为HBV DNA阳性组（n=66）及HBV DNA阴性组（n=132）,并分别比较两组的疾病谱构成比的分布情况。采用SPSS 16.0统计软件,组间均数的比较采用t检验或秩和检验,率的比较采用χ2检验或Fisher′s精确概率法检验,P〈0.05为差异有统计学意义。结果抗病毒组与对照组的疾病谱构成比分布比较差异有统计学意义（P〈0.05）,其中抗病毒组诊断为慢性乙型肝炎（重度）、慢性乙型肝炎（重型）的比例低于对照组（10.0%vs 25.9%,P〈0.05;3.6%vs 13.4%,P〈0.05）,而诊断为乙肝肝硬化的比例高于对照组（74.2%vs 44.8%,P〈0.05）,差异均有统计学意义;规范抗病毒组与不规范抗病毒组的疾病谱构成比分布比较差异亦有统计学意义（P〈0.05）;规范抗病毒组中HBV DNA阳性及阴性亚组的疾病谱构成比分布比较差异亦有统计学意义（P〈0.05）。结论规范且有效的抗病毒治疗确实可以减少慢性乙型肝炎患者因肝炎活动而住院的比例,从而改变住院慢性HBV感染者的疾病谱构成比。

Effects of antiviral therapy on the disease spectrum of inpatients with chronic HBV infection

Objective To investigate the effects of antiviral therapy on the disease spectrum of inpatients with chronic hepatitis B virus（HBV）infection.Methods Inpatients were enrolled throughout the whole year of2011.Previous antiviral therapy experiences were recorded.HBV DNA was detected and liver cirrhosis was evaluated.Results A total of 1619 inpatients with chronic HBV infection hospitalized throughout the whole year of 2011 were enrolled in this retrospective study.All inpatients were divided into pre-antiviral group（n=279）and control group（n=1 340）based on whether the inpatients had previous antiviral therapy experience more than 3months or not.The 279 inpatients in the pre-antiviral group were further divided as standard preantiviral subgroup（n=198）and non-standard pre-antiviral subgroup（n=81）based on whether the patients took medicine regularly or not.Then the standard antiviral subgroup patients were classified as HBV DNA positive（≥100IU/ml,n=66）and HBV DNA negative（100IU/ml,n=132）.Fewer severe chronic hepatitis B and acute-on-chronic liver failure were diagnosed in pre-antiviral group than that in control group（10.0%vs25.9%,P0.05;3.6%vs 13.4%,P0.05,respectively）,while more HBV-related cirrhosis in pre-antiviral group were found than that in control group（74.2%vs 44.8%,P0.05）.Conclusions Standard and effective antiviral therapy could slow down the progress of chronic active hepatitis B.