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为了比较乙型肝炎抗原(HBAg)阳性与HBAg阴性病者的临床过程有无不同,对86例慢性肝病者作了前瞻性研究。其中慢性肝炎45例,肝硬化41例,每例都经临床检查、肝功能及血清学试验,腹腔镜肝脏检查与活检等证实。随访时间平均38个月。慢性肝炎中,19例HBAg阳性。HBAg阳性与阴性病者的临床过程无显著不同(P>0.05)。HBAg阳性的19例中,12例在整个随访时间持续阳性;3例暂时阳性,临床并无明显改变;另4例转阴,均属慢性持续性肝炎,内2例再次活检示病变消散,另2例亦无不适,肝功能接近正常,提示病情无重大发展。34例慢性肝炎病者中,14例有自身抗体(抗核因子、平滑肌抗体、线粒体抗体),其中7例HBAg阳性。HBAg阳性和阴性病者的自身抗体发现率无显著不同
To compare the clinical course of hepatitis B antigen (HBAg) positive with that of HBAg negative patients, 86 patients with chronic liver disease were prospectively studied. Of which 45 cases of chronic hepatitis, liver cirrhosis in 41 cases, each case by clinical examination, liver function and serological tests, laparoscopic liver biopsy confirmed. The average follow-up time was 38 months. In chronic hepatitis, 19 cases of HBAg positive. The clinical course of HBAg-positive and -negative patients was not significantly different (P> 0.05). Among the 19 HBAg-positive cases, 12 cases were persistent throughout the follow-up period; 3 cases were transiently positive and had no clinical changes; the other 4 cases were negative chronic persistent hepatitis. Two cases of re-biopsy showed that the lesions disappeared. No discomfort was found in 2 patients, and the liver function was close to normal, suggesting no significant progression of the disease. Of the 34 patients with chronic hepatitis, 14 had autoantibodies (anti-nuclear factor, smooth muscle antibodies, mitochondrial antibodies), of which 7 were positive for HBAg. There were no significant differences in the autoantibody discovery between HBAg-positive and -negative patients