慢性 HBV 感染者病原学特点与治疗及转归相关性研究

目的：探讨慢性HBV感染者病原学特点与治疗及转归的相关性。方法：根据慢性HBV感染者的病原学特点及有无肝损害情况，将282例慢性HBV感染者分为6组，观察其各项实验室指标的情况。结果： A2型患者HBeAg阴转例数多于A1型患者（ P＜0.05）； A2型患者HBeAg阴转的治疗时间较短于A1型患者（ P＜0.01）； C型患者病毒复制指标反弹的例数多于A型患者（P＜0.05）； C型患者伴有肝硬化的例数多于A型患者（P＜0.01）； C型有肝硬化患者HBV DNA反弹例数多于无肝硬化患者（ P＜0.05）； C型有肝硬化患者HBV DNA清除时间较长于无肝硬化患者（P＜0.05）。结论：双抗原阳性有肝损害的患者HBeAg阴转率较高，治疗时间较短；单抗原HBsAg阳性且HBV DNA阳性感染者较易发展为肝硬化，此型患者病毒清除时间较长且易反弹。因此，对于单抗原HBsAg阳性且HBV DNA阳性感染者，提倡早期治疗，否则进展为肝硬化时，治疗难度增加，病情易反复。

Correlation among etiology character of chronic HBV infection and treat-ment,disease prognosis

Objective： To explore the correlation among etiology character of TCM chronic HBV infection and treatment , disease prognosis.Methods： According to the etiology character of chronic HBV infection and the presence of hepatic injury , the 282 cases of chronic HBV infection were divided into six groups and observed their laboratory indexes .Results： The cases of A2 group with HBeAg transferring negative were more than the groups A 1 （ P〈0.05 ）; the therapy course of A 2 group with transferring negative was shorter in the group A1 （P〈0.01）;comparison of C-type and A-type, the former prone to the rebound of viral replication index （P〈0.05）;the number of C-type patients with cirrhosis was more than the A-type （P〈0.01）; the number of C-type patients with cirrhosis was more than the C-type non-cirrhotic patients （ P〈0.05）; the therapy course of C-type patients with cirrhosis was longer than the C-type non-cirrhotic patients （ P〈0.05 ） .Conclusion： The HBeAg negative rate of double-antigen positive patients with hepatic injury is higher and the therapy course is shorter ;single antigen HBsAg posi-tive and HBV DNA positive patients are likely to develop into liver cirrhosis;this type of patients with viral clearance time is long and easy to rebound.Therefore, for a single antigen HBsAg positive and HBV DNA positive infection , promote early treatment, otherwise the progress to cirrhosis , treatment more difficult , illness capricious.