131例慢性HBV携带者肝脏病理与年龄、HBeAg（±）的相关性研究:乙肝携带者怎样保护肝脏
[摘要] 目的 探讨慢性HBV携带者的肝脏组织病理与年龄、HBeAg（±）的关系，为临床诊疗提供参考。 方法 收集131例慢性HBV携带者肝活检病理结果，按年龄分为三组：＜30岁组，30～40岁组，＞40岁组，计算各组不同炎症分级或纤维化分期者所占比例，比较组间差异。并计算不同炎症分级或纤维化分期HBeAg阳性和阴性患者各占比例，比较组间差异。 结果 113例肝功能正常患者中约30%患者出现明显纤维化；无炎症患者为0，所有患者均有轻度炎症及纤维化；肝组织病理炎症分级、纤维化分期与年龄比较：三组纤维化分期比较差异有高度统计学意义（χ2=18.55，P < 0.01）。G1、G2、G3三组HBeAg阳性率逐步下降，S0、S1、S2三组阳性率逐步下降。 结论 所有患者均有轻度炎症及纤维化，且肝纤维化程度与年龄呈正相关，其中纤维化程度重者以HBeAg阴性者为多，积极进行肝脏活体组织病理检测，对预防疾病发展，指导抗病毒治疗有重要意义。
[关键词] 乙型肝炎病毒；HBeAg；活组织检查
[中图分类号] R512.6 [文献标识码] A [文章编号] 1673-7210（2012）07（c）-0046-03
Relationship between the positive rate of HBeAg, pathology of liver and age in 131 patients with chronic HBV carriers
YANG Yugui WU Jianhua▲ LI Wei ZHANG Quanhui
Department of Hepatopathy, the Sixth People"s Hospital of Zhengzhou City, He"nan Province, Zhengzhou 450000, China
[Abstract] Objective To explore the relationship between the positive rate of HBeAg, pathology of liver and ages in 131 patients with chronic HBV carrier in order to provide the reference for diagnosis of chronic HBV carriers. Methods 131 patients with chronic HBV carrier were selected and randomly divided into three groups according to the age: less than 30-year-old group, from 30-year-old to 40-year-old group and more than 40-year-old group. The inflammation grading and fibration grading in three groups were counted out and the positive rate of HBeAg in distinct Inflammation Grading and (or) fibration Grading of patients was also analysed. Results The fibration of livers were appeared in 30 percent of 131 patients and Inflammation of livers were arised among all the cases. Fibrations of liver in three groups were difference significantly (P ＜ 0.01) and the positive rates of HBeAg in G1, G2, G3 inflammation grading and S0, S1, S2 fibration grading of patients were reducd gradually. Conclusion All 131 paitents have inflammation and fibration, and the fibration grading has positive correlation with age of patients, so the biopsy of liver is useful to manage the progress of disease and to guide the remedy of chronic HBV carrier.
[Key words] HBV carrier; HBeAg; Biopsy
本文主要通过对比分析不同年龄段慢性乙肝病毒（hepatitis B virus，HBV）携带者的肝组织病理改变，探寻患者年龄、乙肝e抗原（HBeAg）与肝脏炎症及纤维化的相关性，为临床诊疗提供参考。
1 资料与方法
1.1 一般资料
选择2008年8月～2010年8月河南省传染病医院5个肝病中心住院经肝穿刺活检的慢性HBV携带者113例，男77例，女36例；年龄15～69岁，平均年龄30.93岁；病史为3～9年，平均4.8年。诊断标准符合我国《慢性乙型肝炎防治指南》[1]。按年龄分为三组：＜30岁组34例，其中男21例，女13例，平均病史4.7年；30～40岁组48例，男31例，女17例，平均病史4.8年；＞40岁组51例，男33例，女18例，平均病史4.9年。三组患者性别及病史比较差异无统计学意义（P ＞ 0.05），具有可比性。