慢性乙型肝炎患者肝脏病理特点与血清HBeAg和HBV DNA的关系

目的 了解慢性乙型肝炎患者病理特点与血清HBeAg和HBVDNA的关系.方法对1057例慢性乙型肝炎患者进行肝脏病理检查,采用荧光定量PCR法检测血清HBV DNA,用化学发光法检测血清HBeAg.结果 HBeAg阴性的慢性乙型肝炎患者的炎症及纤维化程度(G4和S4分别为7.83%和12.17%)较HBeAg阳性的慢性乙型肝炎患者高(G4和S4分别为3.39%和5.44%);HBeAg阳性的患者中HBV DNA滴度低的患者炎症及纤维化程度较高(HBV DNA 104～105 G3G4和S3S4分别为45.64%和30.20%),而HBeAg阴性的患者则是HBV DNA滴度高的炎症及纤维化程度较高(HBV DNA106～107 G3G4为54.55%和HBV DNA 108～109S3S4为42.85%).结论慢性乙型肝炎患者的肝脏病理与血清HBeAg及HBV DNA水平有不同相关性,对HBeAg阴性的慢性乙型肝炎患者要及早进行肝脏病理检查和抗病毒治疗.

Relationship between liver pathological characteristics and serum HBeAg and HBV DNA in patients with chronic hepatitis B

Objective To study the relationship between liver pathological changes and serum HBeAg and HBV DNA in patients with chronic hepatitis B. Methods Liver puncture biopsy for histopathological examinations were performed in 1057 patients with chronic hepatitis B. The quantitative analysis of serum HBV DNA by fluorogenic quantitative PCR and HBeAg by chemoluminescence were also conducted. Results The inflammatory grade and fibrosis stage were higher in HBeAg-negative paients (G4 and S4 were 7.83% and 12.17%respectively) than in HBeAg-positive patients (G4 and S4 were 3.39% and 5.44% respectively). The inflammatory grade and fibrosis stage were higher in HBeAg-positive patients with low-level HBV DNA( G3G4 was 45.64% and S3S4 was 30.20% for HBV DNA 104-105 ), whereas they were higher in HBeAg-negative patients with high-level HBV DNA(G3G4 was 54.55% for HBV DNA 106-107 and S3S4 was 42.85% for HBV DNA 108-109). Conclusion There were some correlation between the liver pathological changes and serum HBeAg and HBV DNA levels in patients with chronic hepatitis B. It is important to perform the liver pathological examination and antiviral therapy as early as possible in patients with HBeAg-negative chronic hepatitis B.