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目的观察乙型肝炎e抗原(HBeAg)阴性慢性乙型肝炎(CHB)及肝硬化患者的乙型肝炎病毒(HBV)基因型及丙氨酸氨基转移酶(ALT)水平。方法采用酶联免疫吸附法检测62例CHB和41例肝硬化患者HBV标志物和血清ALT水平,用聚合酶链反应法检测其HBV基因型。结果CHB患者中,21 例(33.9%)为HBeAg阴性,41例(66.1%)为HBeAg阳性;肝硬化患者中,28例(68.3%)为HBeAg阴性,13例(31.7%)为HBeAg阳性。CHB患者中,53例(85.5%)为C基因型,9例(14.5%)为B基因型; 肝硬化患者中39例(95.1%)为C基因型,2例(4.9%)为B基因型。HBeAg阴性CHB患者ALT>40 U/L 者的比例低于HBeAg阳性组(分别为47.6%和85.4%),差异有统计学意义(P<0.01)。HBeAg阴性肝硬化患者ALT>40 U/L者的比例低于HBeAg阳性组(分别为64.3%和92.3%)但差异无统计学意义。结论CHB 和肝硬化患者中,HBeAg阴性者的比例较高,此类患者的ALT水平较低,以C基因型占优势。
Objective To investigate the levels of hepatitis B virus (HBV) and alanine aminotransferase (ALT) in patients with hepatitis B e antigen (HBeAg) -related chronic hepatitis B (CHB) and cirrhosis. Methods The HBV markers and serum ALT levels in 62 cases of CHB and 41 cases of cirrhosis were detected by enzyme linked immunosorbent assay (ELISA). The HBV genotypes were detected by polymerase chain reaction. Results Among the CHB patients, 21 (33.9%) were HBeAg negative and 41 (66.1%) were HBeAg positive. Among cirrhosis patients, 28 (68.3%) were HBeAg negative and 13 (31.7%) HBeAg positive. Among CHB patients, 53 (85.5%) were C genotypes and 9 (14.5%) were genotype Bs; 39 (95.1%) were C genotypes in cirrhotic patients and 2 (4.9%) were B genes type. The proportion of patients with ALT> 40 U / L in HBeAg-negative CHB patients was lower than that in HBeAg-positive patients (47.6% and 85.4%, respectively). The difference was statistically significant (P <0.01). The proportion of patients with ALT> 40 U / L in HBeAg-negative cirrhotic patients was lower than that in HBeAg-positive patients (64.3% and 92.3% respectively), but the difference was not statistically significant. Conclusions Among patients with CHB and liver cirrhosis, the proportion of HBeAg-negative patients is higher, and the patients with ALT have a lower ALT level. The genotype C predominates.