CAJ | 학술논문

目的：观察慢性乙型肝炎（CHB）患者不同乙型肝炎e抗原（HBeAg）状态与HBV‐DNA载量及肝脏损伤的关系。方法分别采用实时荧光定量PCR法及速率法对258例慢性乙型肝炎进行血清 HBV‐DNA 定量和丙氨酸氨基转移酶（ALT ）检测。以ALT水平对肝脏损伤程度进行分型，对不同HBeAg状态、病毒载量、肝损伤程度进行分析。结果 HBeAg阴性组年龄大于HBeAg阳性组，其血清 HBV‐DNA载量低于 HBeAg阳性组（P＜0．01），肝损伤程度两组比较差异无统计学意义（P＞0．05）。HBeAg阴性组随血清 HBV‐DNA载量增加，肝损伤程度明显升高（P＜0．05），HBeAg阳性组则无相关性。结论 HBeAg阳性是判断HBV复制的良好指标，HBeAg阳性CHB患者体内DNA载量与肝内炎症损伤无关。而HBeAg阴性CHB患者体内 HBV‐DNA与肝脏损伤相关，应重视对HBeAg阴性患者的随访和治疗。
목적：관찰만성을형간염（CHB）환자불동을형간염e항원（HBeAg）상태여HBV‐DNA재량급간장손상적관계。방법분별채용실시형광정량PCR법급속솔법대258례만성을형간염진행혈청 HBV‐DNA 정량화병안산안기전이매（ALT ）검측。이ALT수평대간장손상정도진행분형，대불동HBeAg상태、병독재량、간손상정도진행분석。결과 HBeAg음성조년령대우HBeAg양성조，기혈청 HBV‐DNA재량저우 HBeAg양성조（P＜0．01），간손상정도량조비교차이무통계학의의（P＞0．05）。HBeAg음성조수혈청 HBV‐DNA재량증가，간손상정도명현승고（P＜0．05），HBeAg양성조칙무상관성。결론 HBeAg양성시판단HBV복제적량호지표，HBeAg양성CHB환자체내DNA재량여간내염증손상무관。이HBeAg음성CHB환자체내 HBV‐DNA여간장손상상관，응중시대HBeAg음성환자적수방화치료。
Objective To explore the associations between different HBeAg staus ,serum HBV DNA level and hepatic injury in patients with chronic hepatitis B (CHB) .Methods HBV DNA level and serum ALT were detected by quantitative Real‐time PCR and velocity methods separately .The degree of hepatic injury was determined by the level of ALT ,and the associations between HBV DNA level and hepatic injury both in HBeAg negative CHB and HBeAg positive CHB patients were analyzed accordingly .Re‐sults Elder age and lower HBV DNA level were found in HBeAg negative CHB patients than in HBeAg positive patients (P<0 .01) ,however ,no difference of hepatic injury were found between the two groups (P>0 .05) .Serum HBV DNA level was posi‐tively correlated with the degree of hepatic injury in HBeAg negative CHB patients (P<0 .05) but no similar correlation was found in HBeAg positive patients .Conclusion Positive serum HBeAg is an effective indicator of HBV replication and no correlation is presented between HBV DNA level and intrahepatic inflammation in HBeAg positive CHB patients .However ,HBV DNA level is closely correlated with liver damages in HBeAg negative CHB patients ,more attention should be paid to clinical treatment and fol‐low‐up monitoring of HBeAg negative CHB patients .