CAJ | 학술논문

目的探讨HBeAg阳性与HBeAg阴性慢性重型乙型肝炎患者的临床特征.方法对95例慢性重型乙型肝炎患者的临床资料、肝功能、肝纤维化指标、HBV DNA载量及并发症发生率进行回顾性分析.结果 95例患者中,HBeAg阳性41例(43% ),HBeAg阴性54例(57% ).HBeAg阳性组与HBeAg阴性组平均发病年龄,ALB、TB、CHE、肝纤维化指标及肝衰竭并发症发生率差异无统计学意义(P>0.05).HBeAg阴性患者的ALT、AST分别为(400.37±413.59)U/L和(578.14±600.23)U/L,高于阳性患者的(198.25.4±215.37)U/L和(254.78±269.16)U/L(P<0.05).HBeAg阳性患者的HBV DNA载量为(6.17×10~6±8.24×10~1)copies/ml高于阴性患者的(2.39×10~5±6.75×10~1)copies/ml,两组间具有显著差异(P<0.05).另外HBeAg阳性患者的左肝前后径及右肝厚度分别为(65.12±12.43)mm及(95.37±12.69)mm,均高于阴性患者的(56.78±11.04)mm和(89.34±9.23)mm(P<0.05).结论 HBeAg阴性慢性重型乙型肝炎患者与HBeAg阳性患者相比在较低的HBV DNA载量下,仍引起较高的肝损伤和较大幅度的肝脏萎缩.
목적 탐토HBeAg양성여HBeAg음성만성중형을형간염환자적림상특정.방법 대95례만성중형을형간염환자적림상자료、간공능、간섬유화지표、HBV DNA재량급병발증발생솔진행회고성분석.결과 95례환자중,HBeAg양성41례(43% ),HBeAg음성54례(57% ).HBeAg양성조여HBeAg음성조평균발병년령,ALB、TB、CHE、간섬유화지표급간쇠갈병발증발생솔차이무통계학의의(P>0.05).HBeAg음성환자적ALT、AST분별위(400.37±413.59)U/L화(578.14±600.23)U/L,고우양성환자적(198.25.4±215.37)U/L화(254.78±269.16)U/L(P<0.05).HBeAg양성환자적HBV DNA재량위(6.17×10~6±8.24×10~1)copies/ml고우음성환자적(2.39×10~5±6.75×10~1)copies/ml,량조간구유현저차이(P<0.05).령외HBeAg양성환자적좌간전후경급우간후도분별위(65.12±12.43)mm급(95.37±12.69)mm,균고우음성환자적(56.78±11.04)mm화(89.34±9.23)mm(P<0.05).결론 HBeAg음성만성중형을형간염환자여HBeAg양성환자상비재교저적HBV DNA재량하,잉인기교고적간손상화교대폭도적간장위축.
Objective To investigate the clinical characteristics in chronic severe hepatitis B patients with HbeAg-positive and HbeAs-negative.Methods A total of 95 chronic severe hepatitis B cases were retrospectively analyzed.The clinical information,hepatic function,hepatic fibrosis and HBV DNA in HBeAg-negative and HBeAgpositive groups were analyzed.Results of the 95 cases,54(57% ) were HBeAg-negative and 41(43% ) were HBeAg-positive.No significant differences were found on age,ALB,TB,CHE,indexes of hepatic fibrosis and the ratio of complications between HBeAg-negative group and HBeAg-positive group.Compared with HBeAg-positive group,there were significantly higher levels of ALT(198.25±215.37)U/L vs(400.37±413.59)U/L],AST[(254.78±269.16)U/L vs(578.14±600.23)U/L] and lower level of HBV DNA[(6.17×10~6±8.24×10~1)copies/ml vs (2.39×10~5±6.75×10~1) copies/ml] in HBeAg-negative group(P<0.05).The anteroposterior diameter of the left liver and the thickness of right liver were(65.12±12.43)mm and(95.37.±12.69)mm in the HBeAg positive fatal chronic severe hepatitis B before the terminal phase,vs(56.78±11.04)mm and(89.34.±9.23)mm in the HBeAg negative group,and the former is longer than the later(P<0.05).Conclusion Tissue injury is more serious and the level of HBV DNA is lower in HBeAg-negative patients than HBeAg-positive patients.Liver size of HBeAg negative group reduces more significantly than HBeAg positive group before terminal phase.