中华临床感染病杂志
中華臨床感染病雜誌
중화림상감염병잡지
CHINESE JOURNAL OF CLINICAL INFECTIOUS DISEASES
2011年
4期
227-230
,共4页
肝炎,乙型,慢性%肝炎e抗原,乙型%病理学
肝炎,乙型,慢性%肝炎e抗原,乙型%病理學
간염,을형,만성%간염e항원,을형%병이학
Chronic hepatitis B%Hepatitis B e antigens%Histopathology
目的 探讨HBeAg阳性和阴性慢性乙型肝炎(CHB)的临床病理学差异.方法 选择2002年6月-2010年1月在宁波市第二医院住院并做活体肝组织穿刺病理学诊断的CHB患者665例,其中HBeAg阳性组428例,HBeAg阴性组237例,对两组患者的血清HBV DNA载量、肝组织病理变化结果进行对比分析.采用SPSS 11.5软件进行统计学处理,计量资料采用t检验(正态分布)或Mann-Whitney U检验(偏态分布),计数资料用卡方检验,相关性分析采用Pearson法.结果 HBeAg阴性与阳性患者在肝组织炎症分级和纤维化分期的构成上差异有统计学意义(x2=7.92和10.35,P值均＜0.01),HBeAg阴性组的炎症分级、纤维化分期高于HBeAg阳性组.HBeAg阴性患者血清HBV DNA水平在＜3、≥3～＜5 log10拷贝/mL的比例明显高于HBeAg阳性组(x2=105.16和36.92,P值均＜0.01),而≥7 log10拷贝/mL所占的比例较HBeAg阳性组低(x2=110.18,P＜0.01).随着血清HBV DNA水平的上升,HBeAg阳性CHB患者肝组织炎症分级和纤维化分期呈下降趋势(r=-0.287和-0.224,P＜0.01),而在HBeAg阴性CHB患者中则呈上升趋势(r=0.360和0.303,P＜0.01).结论 HBeAg阴性CHB患者肝组织损伤较HBeAg阳性患者更加严重,须密切监测.
目的 探討HBeAg暘性和陰性慢性乙型肝炎(CHB)的臨床病理學差異.方法 選擇2002年6月-2010年1月在寧波市第二醫院住院併做活體肝組織穿刺病理學診斷的CHB患者665例,其中HBeAg暘性組428例,HBeAg陰性組237例,對兩組患者的血清HBV DNA載量、肝組織病理變化結果進行對比分析.採用SPSS 11.5軟件進行統計學處理,計量資料採用t檢驗(正態分佈)或Mann-Whitney U檢驗(偏態分佈),計數資料用卡方檢驗,相關性分析採用Pearson法.結果 HBeAg陰性與暘性患者在肝組織炎癥分級和纖維化分期的構成上差異有統計學意義(x2=7.92和10.35,P值均＜0.01),HBeAg陰性組的炎癥分級、纖維化分期高于HBeAg暘性組.HBeAg陰性患者血清HBV DNA水平在＜3、≥3～＜5 log10拷貝/mL的比例明顯高于HBeAg暘性組(x2=105.16和36.92,P值均＜0.01),而≥7 log10拷貝/mL所佔的比例較HBeAg暘性組低(x2=110.18,P＜0.01).隨著血清HBV DNA水平的上升,HBeAg暘性CHB患者肝組織炎癥分級和纖維化分期呈下降趨勢(r=-0.287和-0.224,P＜0.01),而在HBeAg陰性CHB患者中則呈上升趨勢(r=0.360和0.303,P＜0.01).結論 HBeAg陰性CHB患者肝組織損傷較HBeAg暘性患者更加嚴重,鬚密切鑑測.
목적 탐토HBeAg양성화음성만성을형간염(CHB)적림상병이학차이.방법 선택2002년6월-2010년1월재저파시제이의원주원병주활체간조직천자병이학진단적CHB환자665례,기중HBeAg양성조428례,HBeAg음성조237례,대량조환자적혈청HBV DNA재량、간조직병리변화결과진행대비분석.채용SPSS 11.5연건진행통계학처리,계량자료채용t검험(정태분포)혹Mann-Whitney U검험(편태분포),계수자료용잡방검험,상관성분석채용Pearson법.결과 HBeAg음성여양성환자재간조직염증분급화섬유화분기적구성상차이유통계학의의(x2=7.92화10.35,P치균＜0.01),HBeAg음성조적염증분급、섬유화분기고우HBeAg양성조.HBeAg음성환자혈청HBV DNA수평재＜3、≥3～＜5 log10고패/mL적비례명현고우HBeAg양성조(x2=105.16화36.92,P치균＜0.01),이≥7 log10고패/mL소점적비례교HBeAg양성조저(x2=110.18,P＜0.01).수착혈청HBV DNA수평적상승,HBeAg양성CHB환자간조직염증분급화섬유화분기정하강추세(r=-0.287화-0.224,P＜0.01),이재HBeAg음성CHB환자중칙정상승추세(r=0.360화0.303,P＜0.01).결론 HBeAg음성CHB환자간조직손상교HBeAg양성환자경가엄중,수밀절감측.
Objective To identify the differences in clinicopathological features between HBeAg-positive and HBeAg-negative chronic hepatitis B (CHB). Methods A total of 665 CHB patients who were admitted to Ningbo No. 2 Hospital during June 2002 and January 2010 were enrolled, in which 428 were HBeAg-positive and 237 were HBeAg-negative. HBV DNA loads, live histological inflammation grades and fibrosis stages were compared between two groups. SPSS 1 1. 5 was used for statistical analysis. For measurement data, t (for normal distribution) or Mann-Whitney U (for skew distribution) was performed; for enumeration data, Chi-square test was performed; and Pearson correlation analysis was conducted. Results Liver inflammatory grade and fibrosis staging in HBeAg-negative CHB patients were more severe than those in HBeAg-positive patients (x2 = 7.92 and 10.35, P ＜ 0. 01 ). The ratio of serum HBV DNA levels ＜ 3, ≥3- ＜ 5 log10 copies/mL in HBeAg-negative CHB patients were significant higher than those in HBeAg-positive patients (x2 = 105.16 and 36.92 ,P ＜0.01 ) ; and the ratio of HBV DNA ≥7 log10 copies/mL in HBeAg-negative group was lower than that in HBeAg-positive group (x2 = 110. 18, P ＜0. 01 ). With the rising of serum HBV DNA levels, liver inflammatory grade and fibrosis staging in HBeAg-positive patients had a descending tendency (r =-0. 287 and-0. 224, P ＜0.01 ), while those in the HBeAg-negative group were ascending (r = 0. 360 and 0. 303, P ＜ 0. 01 ). Conclusion Compared with HBeAg-positive CHB patients, liver inflammation and tissue damage in HBeAg-negative patients are more severe, which need close monitoring.
