慢性B型肝炎e抗原陽性與e抗體陽性病例之臨床與組織學比較

Comparison of Clinical and Histological Features Between Hbeag-Positive and Anti-Hbc-Positive Chronic Type B Hepatitis

朱嘉明(Chia-Ming Chu) ； 廖運範(Yun-Fan Liaw) ； 陳東榮(Tong-Jong Chen) ； 林灯寅(Deng-Yn Lin) ； 沈一嫻(I-Shyan Sheen) ； 黃妙珠(Miau-Ju Huang)

《中華民國消化系醫學會雜誌》 2卷3期 (1985/09) Pp. 136-141

https://doi.org/10.6557/GJTa.198509_2(3).0003

摘要

The incidence of hepatitis B e antigen (HBeAg) and antibody (anti-HBe) in chronic type B hepatitis was studied using radioimmunoassay, and the clinical and histoogical featrues were compared between HBeAg-positive and anti-HBe-positive patients. Of the 389 patients with chronic type B heptitis, 268 (68.9%) were positive for HBeAg, 107 (27.5%) were positive for anti-HBe and the other 14 (3.6%) were negative for both. The prevalence of HBeAg was around 80% in chronic lobular hepatitis (CLH) and chronic active hepatitis(CAH), around 60% in nonspecific reactive hepatitis (NSRH) and chronic persistent hepatitis (CPH) (P＜0.01), and around 40% in CAH with cirrhosis (P＜0.05 vs CPH ﹠ NSRH, P＜0.001 vs CLH and CAH).The mean age was significantly lower in HBeAg-positive patients, than in anti-HBe-positive ones (30.8±9.3 vs 40.9±11.0, P＜0.001), and males were significantly less predominant in HBeAg-positive cases than in anti-HBe-positive ones (86.2% vs 93.5%, P＜0.001). The HBeAg-positive cases have significantly higher biochemical and histological activity, than do anti-HBe-positive ones; as 60.5% of the former had SGPT＞200 IU/L, compared to only 34.6% of the latter (P＜0.001); and 68.3% of the former were CLH or CAH, in contrast to 40.2% of the latter (P＜0.001). Histological evidence of cirrhosis was more commonly seen in anti-HBe-positive cases, than in HBeAg-positive ones (29.0% vs 7.8%, P＜0.001).Among patients with SGPT＜200 IU/L. 46.2% of the HBeAg-positive cases were NSRH, and 6.6% were CAH with cirrhosis, whereas CAH with cirrhosis was seen in 31.4% of anti-HBe-positive cases with SGPT＜200 IU/L (P＜0.001). Among patients with SGPT＞200 IU/L, CLH was more common in the HBeAg-positive cases, than in anti-HBe-positive ones (51.2% vs 29.8%，P＜0.05), whereas CAH was more common in anti-HBe-positive cases, than in HBeAg-positive ones (for CAH with cirrhosis, 24.3% vs 8.6%, P＜0.05; for CAH with or without cirrhosis, 62.1% vs 46.3%, P=0.08). These observations might implicate that the immunopathogenesis of lobular and periportal hepatic necrosis could be quite different.

關鍵字

慢性B型肝炎 ； e抗原/e抗體 ； 生化學活性 ； 組織學活性

並列摘要

無資料

並列關鍵字

Chronic B hepatitis ； HBeAg/anti-HBe ； biochemical activity ； histological activity