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摘要: 目的从临床及病理学两个层面分析HBeAg阴性与HBeAg阳性慢性乙型肝炎(以下简称慢乙肝)的特征,比较其血清生化指标变化、病毒载量水平及肝组织病理改变的特点。方法选取慢性乙型肝炎(CHB)患者67例,行超声引导下快速肝穿刺活检,并分别检测血清ALT、AST、TBil、A/G及HBVDNA定量,将结果进行对比分析。结果67例CHB患者中,HBeAg阴性24例(35.82%),阳性43例(64.18%)。HBeAg阴性慢乙肝与HBeAg阳性慢乙肝比较,阴性组血清ALT水平升高较阳性组明显,差异有统计学意义(P<0.05);其血清AST、TBil、A/G两组比较均无明显差异。两组HBVDNA定量水平比较,阴性组低于阳性组,差异有统计学意义(P<0.05)。两组肝组织病理学改变无明显差异(P>0.05)。结论HBeAg阴性慢乙肝患者存在不同程度肝功能损害和病理损伤,应给予高度重视,有条件时应进行肝穿刺活检,以便及早诊断和治疗。Abstract: Objective To characterize the clinical and pathological features of HBeAg (-) and (+) chronic hepatitis B patients by comparing serum biochemistry indices, virus load and liver pathology.Methods In 67 chronic hepatitis B (CHB) patients, liver biopsy, ALT, AST, TBil, A/G and HBVDNA were conducted respectively.The results were then analyzed between HBeAg (-) and (+) groups.Results Among 67 patients, 24 were HBeAg (+) (35.82%) , while 43 HBeAg (-) (64.18%) .Serum ALT level was significantly high in HBeAg (-) group than HBeAg (+) group (P<0.05) .No significant differences were observed in serum AST, TBil and A/G.HBVDNA load was significantly lower in HBeAg (-) group than HBeAg (+) group (P<0.05) .The liver pathologic observation found no obvious differences within two groups (P>0.05) .Conclusion HBeAg (-) CHB patients have varied damages to liver function and histology;they should be paid enough attentions.If possible, liver biopsy should be done for the early diagnosis and treatment.
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Key words:
- HBeAg (-) /
- CHB /
- liver pathology
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