HBeAg 阳性与阴性乙型肝炎肝硬化患者乙肝病毒载量及肝功能指标的研究

目的 探讨乙肝e 抗原（HBeAg）阳性与阴性乙型肝炎肝硬化患者病毒载量及肝功能指标的差异并分析其临床意义。方法 采用回顾性分析方法，收集2015 年2 月-2016 年2 月在该院住院的乙型肝炎肝硬化患者270 例，分析HBeAg 阳性（124 例）和HBeAg 阴性（146 例）乙型肝炎肝硬化患者的乙肝表面抗原（HBsAg）、HBV DNA、肝功能指标（ALT、AST、TBIL、ALB）的差异及不同HBV DNA 载量的构成比。结果 HBeAg阳性组HBsAg、HBV DNA、ALT、AST 的含量与HBeAg 阴性组比较，差异有统计学意义（P <0.05），HBeAg阳性组均高于HBeAg 阴性组的患者；两组间TBIL、ALB 的比较，差异无统计学意义（P >0.05）。HBeAg阳性组HBV DNA<103 IU/ml 及103 ～ 105 IU/ml 患者的比例均低于HBeAg 阴性组；HBeAg 阳性组HBVDNA>105 IU/ml 患者的比例高于HBeAg 阴性组，两组间HBV DNA 水平的构成比差异有统计学意义（P <0.05）。结论 随着乙肝肝硬化患者体内HBeAg 的血清学转换，乙肝病毒复制水平降低，肝脏炎症反应减弱，但并不意味着病情得到控制，有可能肝脏损害逐渐加重，仍需积极抗病毒治疗。

Study on hepatitis B virus load and liver function indices in patientswith HBeAg-positive and HBeAg-negative hepatitis B cirrhosis

Objective To investigate the differences of HBV load and liver function indexes between HBeAgpositiveand HBeAg-negative hepatitis B cirrhosis patients and to analyze its clinical significance. Methods Inthis retrospective study, 270 cases of liver cirrhosis were collected from February 2015 to February 2016 in theAffiliated Hospital of North China University of Science and Technology. The differences of HBsAg, HBV DNA,liver function indexes (ALT, AST, TBIL and ALB) and the composition ratio of different HBV DNA loads betweenthe HBeAg-positive (124 cases) and HBeAg-negative (146 cases) patients with hepatitis B cirrhosis were analyzed.Results The content of HBsAg, HBV DNA, ALT and AST in the HBeAg-positive group apparently exceeded thatin the HBeAg-negative group (P < 0.05). There was no significant difference in TBIL or ALB between the twogroups (P > 0.05). The proportions of the patients with HBV DNA below 103 IU/ml and between 103 and 105 IU/mlin the HBeAg-positive group were lower than those in the HBeAg-negative group. The proportion of the patientswith HBV DNA over 105 IU/ml in the HBeAg-positive group was higher than that in the HBeAg-negative group,there was a significant difference in the ratio of HBV DNA between the two groups (P < 0.05). Conclusions Withseroconversion of HBeAg in the patients with hepatitis B cirrhosis, the level of hepatitis B virus replication decreases and the liver inflammatory response is reduced, but it does not mean that the disease is under control. It is possible that the liver damage will aggravate gradually, and active antiviral therapy is still necessary.