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目的通过大样本横断面回顾性调查,了解HBeAg(-)和HBeAg(+)两类慢性乙型肝炎(CHB)患者临床相关因素的异同。方法对1686例CHB患者的住院病历进行回顾性调查,分析HBeAg(-)和HBeAg(+)CHB患者ALT、HBV DNA定量、肝组织病理(炎症及纤维化)等指标的组内和组间差异。结果HBeAg(-)CHB628例,占37·3%;HBeAg(+)CHB1058例,占62·7%。HBeAg(+)组ALT、HBV DNA总体上均高于HBeAg(-)组。HBeAg(+)组肝组织炎症及纤维化程度总体上均轻于HBeAg(-)组。结论目前我国CHB病例以HBeAg(+)者占多数。无论HBeAg(-)或HBeAg(+)CHB,肝炎活动在病毒复制活跃时均重于病毒复制水平较低时。HBeAg(-)CHB肝组织学损害重于HBeAg(+)CHB。
Objective To investigate the similarities and differences of clinically relevant factors between two types of patients with chronic hepatitis B (HBeAg) and HBeAg (+) through large sample cross-sectional retrospective investigation. Methods A retrospective study was conducted on the medical records of 1686 CHB patients. The intra-and inter-group differences of ALT, HBV DNA quantitation, liver histopathology (inflammation and fibrosis) in patients with HBeAg (-) and HBeAg (+) CHB were analyzed. . Results HBeAg (-) CHB628 cases, accounting for 37.3%; HBeAg (+) CHB1058 cases, accounting for 62.7%. The levels of ALT and HBV DNA in HBeAg (+) group were generally higher than those in HBeAg (-) group. Liver inflammation and fibrosis in HBeAg (+) group were generally lighter than those in HBeAg (-) group. Conclusion At present, HBeAg (+) is the majority of CHB cases in China. Regardless of HBeAg (-) or HBeAg (+) CHB, hepatitis activity was both greater when virus replication was active than when viral replication was low. Histological lesions of HBeAg (-) CHB are more severe than HBeAg (+) CHB.