摘要
目的探讨血常规、Child-Pugh分级、肝功能及HBV-DNA在HBe Ag阴性及阳性乙肝肝硬化患者中的区别,分析HBe Ag阴性及阳性与乙肝肝硬化患者疾病进展间的关系。方法选取2013年2月至2015年2月间收治的乙肝肝硬化患者215例,根据HBe Ag检测结果分成HBe Ag阴性组(137例)与HBe Ag阳性组(78例)。分别检测两组患者的血常规指标白细胞计数(WBC)、血小板计数(PLT)、血红蛋白(HB),肝功能指标丙氨酸氨基转移酶(ALT)、血清总胆红素(TBIL)、白蛋白(ALB)、前白蛋白(PA)、凝血酶原活动度(PTA)及HBV-DNA荧光定量PCR检测;并分别记录两组患者的性别构成比、年龄、病程及Child-Pugh分级。结果两组患者性别构成及病程方面比较差异无统计学意义(P>0.05);HBe Ag阴性组年龄显著大于阳性组,差异有统计学意义(P<0.05)。HBe Ag阴性组血常规指标WBC及PLT均显著低于阳性组,差异有统计学意义(P<0.05);HBe Ag阴性组肝功能指标ALT显著低于阳性组,差异有统计学意义(P<0.05);在Child-Pugh分级方面,HBe Ag阴性组B级患者比例显著低于阳性组,而C级患者比例显著高于阳性组,差异均有统计学意义(P<0.05);HBe Ag阴性组HBV-DNA荧光定量检测的阳性率显著低于阳性组,差异均有统计学意义(P<0.05)。结论与HBe Ag阳性肝硬化患者相比,HBe Ag阴性患者的肝硬化程度及炎症反应较为严重,且肝脏储备功能较差;但HBe Ag阳性患者应该更加积极地配合治疗,以防止HBV突变株的产生、肝硬化的加重及进展成为肝癌。
Objective To investigate the difference of the blood,child Pugh classification,liver function and HBV- DNA in patients with HBeAg negative and HBeAg positive hepatitis B cirrhosis,and analysis the relationship between disease progression in patients with HBeAg negative and HBeAg positive hepatitis B and liver cirrhosis. Methods From February 2013 to February 2015 in our hospital,215 cases with liver cirrhosis were divided into two groups according to HBeAg detection results,HBeAg negative group（ 137 cases） and HBeAg positive group（ 78cases）. Routine blood indexes of white cell count（ WBC）,platelet count（ PLT）,hemoglobin（ HB）,and liver function index of alanine amino transferase（ ALT）,serum total bilirubin（ TBIL）,albumin（ ALB）,and prealbumin（ PA）,prothrombin activity（ PTA）,and HBV- DNA by fluorescent quantitative PCR were detected; then record the gender,age,course of disease and child Pugh classification of the two groups. The difference in gender,age,course of disease,the hemogram,liver function,child Pugh classification of patients in the two groups were compared.Results There was no significant difference between the two groups in gender and disease course（ P〉0. 05）; the age of HBeAg negative group was significantly higher than the positive group,the difference was statistically significant（ P〈0. 05）. In HBeAg negative group,WBC and PLT were significantly lower than that in the positive group,the difference was statistically significant（ P〈0. 05）. HBeAg negative group ALT of liver function index was significantly lower than that of the positive group,the difference was statistically significant（ P〈0. 05）; in child Pugh classification,the proportion of patients with HBeAg negative group B was significantly lower than that of positive group,and the proportion of patients with grade C was significantly higher than that of the positive group,differences were statistically significant（ P〈0. 05）; the positive rate of HBeAg negative group,HBV- DNA fluorescence quantitative detection was significantly lower than that of the positive group,the differences were statistically significant（ P〈0. 05）. Conclusion Compared with HBeAg positive liver cirrhosis patients,HBeAg negative patients with liver cirrhosis and inflammatory reaction are more serious,and the liver reserve function is poor,but HBeAg positive patients should be actively cooperate with the treatment,to prevent the generation of HBV mutant strain,and the increase of liver cirrhosis and into the development of liver cancer.
出处
《临床和实验医学杂志》
2016年第10期984-986,共3页
Journal of Clinical and Experimental Medicine
