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对40例经临床及肝穿刺病理诊断的 HBsAg 阳性及 HBeAg 阳性的慢性病毒性肝炎病例的 e 系统追踪4～25月。12例出现抗 HBe 转化,12例 HBeAg 阴转,其余16例 HBeAg 持续阳性,据此分三组观察。结果表明:向抗 HBe 转化组中血清 HBsAg 滴度低于 HBeAg 阳性持续组(P<0.05),而其急性期 SGPT 水平则高于后者(P<0.01),该组病人多有急性肝炎病史。在缓解期,该组病例约有半数表现临床症状、肝功能、DNA-P 活性等全面好转,血消 HBsAg 阴转或转为低滴度,其近期预后明显优于 HBeAg 阳性持续组。对慢性乙型肝炎病程中出现 HBeAg 向抗-HBe 转化的有关因素、临床特点和转归问题进行了分析和讨论。
Forty cases of HBsAg-positive and HBeAg-positive patients with chronic viral hepatitis diagnosed by clinical and liver biopsy were followed up for 4 months to 25 months. 12 cases of anti-HBe transformation, 12 cases of HBeAg negative, the remaining 16 cases of HBeAg continued positive, accordingly divided into three groups observed. The results showed that the titer of serum HBsAg in HBeAg-resistant group was lower than that in HBeAg-positive group (P <0.05), while the level of SGPT in acute phase was higher than that in HBeAg-positive group (P <0.01) . In the remission period, about half of the patients in this group showed clinical symptoms, liver function and DNA-P activity were all improved. Blood HBsAg was negative or turned to low titer. The prognosis of HBsAg group was significantly better than that of HBeAg-positive group. In the course of chronic hepatitis B HBeAg to anti-HBe conversion factors, clinical features and prognosis were analyzed and discussed.