慢性乙型肝炎肝损伤患者临床特征及e抗原关系.docVIP

慢性乙型肝炎肝损伤患者临床特征及e抗原关系 　【摘要】 目的： 对轻度及中度肝损伤的e 抗原(Hepatitis B e antigen, HBeAg) 阳性慢性乙型肝炎(chronic hepatitis B, CHB)和e 抗原阴性CHB 患者的临床特征进行比较。方法： 对44例HBeAg阳性CHB和36例HBeAg阴性CHB进行病史询问，检测肝功能、血常规、血清乙型肝炎病毒（HBV）免疫学标志和HBV DNA，并进行腹部B超检查。结果： HBeAg阳性CHB组和HBeAg阴性CHB组在性别构成比例、HBV感染阳性家族史和肝脾肿大方面差异无显著意义（P＞0.05）。HBeAg阳性CHB组和HBeAg阴性CHB组平均年龄分别为（29.23±8.246）岁和（41.53±13.146）岁(P＜0.001)；HBV感染年限≥5年者分别占36.36%和63.89% (P＜0.05)；HBV DNA滴度对数值平均为8.27±1.328和6.02±1.536(P＜0.01)。结论： 在2组患者肝功能、血常规等临床特征一致的情况下，HBeAg 阴性CHB患者有年龄偏大、感染年限较长和HBV DNA滴度较低的特点。 【关键词】 肝炎e 抗原,乙型; 肝炎,乙型; 病例对照研究 ［Abstract］ Objective: To compare the clinical features of chronic hepatitis B (CHB) between types of Hepatitis B e antigen (HBeAg) positive and HBeAg negative. Methods: Investigation on 44 CHB patients with positive HBeAg (HBe-P) and 36 CHB patients with negative HBeAg (HBe-N) were carried out including asking disease histories, checking liver function, testing blood routine, and detection of HBV immunological marks and HBV DNA. Results: No significant difference was found in sex, family history of HBV positive infection, or splenohepatomegalia between groups HBe-P and HBe-N, of which the average patient age were 29.23±8.246 and 41.53±13.146 (Plt;0.001), the percent of patients with disease period longer than 5 years were 36.36% and 63.89% (Plt;0.05), and the average HBV DNA titre logarithm were 8.27±1.328 and 6.02±1.536 (Plt;0.001) respectively. Conclusions: Given similar clinical conditions such as same liver function level and blood routine indexes, CHB patients with negative HBeAg have older age, longer disease period, and lower HBV DNA titer than those of CHB patients with positive HBeAg. ［Key words］ hepatitis B e antigens; hepatitis B; case-control studies 慢性乙型肝炎（chronic hepatitis B, CHB）患者根据血清e抗原（hepatitis B e antigen, HBeAg）的状况可以分为HBeAg 阳性和阴性两种。HBeAg 阴性的慢性乙型肝炎在慢性乙型肝炎患者中所占的比例逐年增高，并在临床表现、预后、抗病毒治疗的方案与应答等诸多方面, 与HBeAg 阳性的慢性乙型肝炎存在显著的差别[1,2]。现就2007 年2月~2008 年3 月在贵阳医学院附属医院感染科门诊就诊的轻度至中度肝损伤HBeAg阳性和阴性CHB患者的基本临床特征做一比较。 1 对象与方法 1.1 研究