40岁以上HBeAg阳性和阴性慢性乙型肝炎病毒感染者的临床特点比较

目的探讨40岁以上HBeAg阳性和HBeAg阴性慢性HBV感染者的临床特点。方法收集40岁以上慢性HBV感染者共186例,其中HBeAg阳性组93例,HBeAg阴性组93例。结果 40岁以上HBeAg阳性慢性HBV感染者男性为多(76.34%),并且多有乙型肝炎家族聚集现象(78.49%);40岁以上HBeAg阳性慢性HBV感染者的HBV DNA水平与ALT水平均高于HBeAg阴性慢性HBV感染者;40岁以上乙型肝炎肝硬化患者中,HBeAg阳性者占少数;40岁以上乙型肝炎肝硬化失代偿期患者中,HBeAg阳性者多合并腹水形成,而HBeAg阴性者既可见腹水形成,又可见上消化道出血。结论 40岁以上HBeAg阳性慢性HBV感染者多见于男性,多具有家族聚集现象,HBeAg阳性肝硬化患者所占比率较低,但HBV DNA水平较高,肝脏的炎症活动明显,病情进展可能较快。

Clinical differences between HBeAg - positive and - negative chronic hepatitis B patients over 40 - years - old

Objective To determine the differential clinical characteristics between hepatitis B e antigen(HBeAg)-positive and-negative patients with chronic hepatitis B virus(HBV) infection who are over 40-years-old.Methods A total of 186 patients with chronic HBV and over 40-years-old were analyzed,including 93 HBeAg-positive patients and 93 HBeAg-negative patients.Results In the HBeAg-positive group,76.34% were male and 78.49% had a family history of HBV infection.The HBeAg-positive group had higher levels of HBV DNA and ALT,and a higher proportion of cirrhosis cases,than the HBeAg-negative group.Ascites were detected in patients from both groups diagnosed with decompensated cirrhosis.Upper gastrointestinal bleeding was more frequent in the HBeAg-negative group.Conclusion In our study of chronic HBV patients over 40-years-old,HBeAg-positivity was more frequent in males with a family history of HBV.HBeAg-negativity was more frequently associated with liver cirrhosis.It is possible that progression of chronic HBV may be related to high levels of HBV DNA and persistent liver inflammation.