Abstract：【Objective】To investigate the clinical value of T lymphocyte subsets, hepatitis B surface antigen (HBsAg) and hepatitis Be antigen (HBeAg) in evaluating different pathological states of patients with hepatitis B.【Methods】A total of 85 cases of hepatitis B patients admitted to our hospital from May 2020 to May 2023 were selected. Pathological examination results showed that 48 cases had inflammation grade < 2, of which 37 cases had inflammation grade ≥2, of which 36 cases had fibrosis stage < 2, and 49 cases had fibrosis stage ≥2. The levels of HBsAg, HBeAg and T lymphocyte subsets in patients with different fibrosis stages and inflammatory grades were compared, and the clinical value of HBsAg,HBeAg and T lymphocyte subsets were analyzed by receiver operating characteristic (ROC) curve to evaluate the different pathological status of hepatitis B patients.【Results】The levels of HBsAg and HBeAg in patients with fibrosis stage ≥2 were significantly lower than those with fibrosis stage < 2, the difference was statistically significant (P<0.05). There was no significant difference in CD4+ and CD8+ levels among hepatitis B patients with different fibrosis stages (P>0.05). ROC curve analysis showed that HBsAg and HBeAg levels had better clinical efficacy in predicting fibrosis stage ≥2, and the area under the curve were 0.772 and 0.821, respectively (P<0.05). HBsAg, HBeAg and CD8+ levels in patients with inflammation grade ≥2 were significantly lower than those with inflammation grade < 2, and CD4+ levels were significantly higher than those with inflammation grade < 2, with statistical significance (P<0.05). ROC curve analysis showed that HBsAg, HBeAg, CD4+, CD8+ levels had better clinical efficacy in predicting inflammation grade ≥2, and the area under the curve was 0.785, 0.808, 0.644, 0.683, with statistical significance (P<0.05).【Conclusion】HBsAg and HBeAg levels and immune function are abnormal in patients with hepatitis B in different pathological states, and the levels of HBsAg, HBeAg and T lymphocyte subsets can be jointly detected in clinic to better evaluate the disease progression of patients.
康敏荣, 周慧芳, 金枝, 戴雪娥, 闫伟. T淋巴细胞亚群、HBsAg、HBeAg评估乙肝患者不同病理状态的临床价值[J]. 医学临床研究, 2025, 42(2): 268-271.
KANG Minrong, ZHOU Huifang, JIN Zhi, et al. The Clinical Value of T Lymphocyte Subsets, HBsAg and HBeAg in Evaluating Different Pathological States of Patients with Hepatitis B. JOURNAL OF CLINICAL RESEARCH, 2025, 42(2): 268-271.
[1] 陶军秀,李晓东,高小莲,等.抗病毒治疗慢性乙型肝炎患者的生存质量影响因素研究[J].中国全科医学,2019,22(23):2798-2804. [2] 李洁萍,王旭,富凡春,等.慢性乙型肝炎病毒感染患者血清IL-12和VEGF及IP-10蛋白水平与疾病进展的相关性[J].中华医院感染学杂志,2020,30(20):3047-3051. [3] WANG M F, WAN B, WU Y L, et al. Clinic-pathological features of metabolic associated fatty liver disease with hepatitis B virus infection[J].World J Gastroenterol,2021,27(4):336-344. [4] LEE W M, KING W C, SCHWARZ K B, et al. Prevalence and clinical features of patients with concurrent HBsAg and anti-HBs: Evaluation of the hepatitis B research network cohort[J].J Viral Hepat,2020,27(9):922-931. [5] LIU L, LIU C Y, LI J Y, et al. Analysis of pathological changes and related factors in liver tissue of HBeAg-negative patients with low HBsAg levels[J].Clin Exp Med,2020,20(4):577-586. [6] 中华医学会传染病与寄生虫病学分会, 肝病学分会. 病毒性肝炎防治方案[J].中华肝脏病杂志, 2000,8(6):324. [7] 中华医学会感染病学分会,中华医学会肝病学分会.慢性乙型肝炎防治指南(2019年版)[J].中华肝脏病杂志,2019,27(12):938-961. [8] TANG J, WU Z Y, DAI R J, et al.Hepatitis B virus-persistent infection and innate immunity defect: Cell-related or virus-related?[J].World J Clin Cases,2018,6(9):233-241. [9] CHO Y Y, CHANG Y, NAM J Y, et al. Long-term nucleotide analogue treatment has higher levels of renal toxicities than does entecavir in patients with chronic hepatitis B[J].Gut Liver,2020,14(2):225-231. [10] 贾瑞,王文鑫,高莹莹,等.血清RANTES早期下降可预测联合聚乙二醇干扰素α治疗核苷(酸)类似物经治慢性乙型肝炎患者的HBsAg清除[J].中华肝脏病杂志,2021,29(7):666-672. [11] 辛菊梅.慢性乙型肝炎及肝硬化患者HBsAg和HBV DNA定量检测的临床意义[J].临床输血与检验,2020,22(2):203-205. [12] 杨美荣,孟冬梅,方正亚.乙型肝炎后肝硬化并发原发性肝癌患者乙型肝炎病毒定量检测的临床意义[J].中国现代医学杂志,2019,29(1):76-79. [13] 赵海燕,杨东,洪伟,等.慢性乙型肝炎、乙肝肝硬化患者中HBV-DNA水平、HBV-M、淋巴细胞亚型特点分析[J].广东医学,2019,40(3):432-435. [14] 李虎,彭明利,陈敏,等.乙型肝炎病毒PreC/C及S基因抗原表位突变对慢性乙型肝炎患者HBeAg血清学状态的影响[J].中华肝脏病杂志,2020,28(7):586-590. [15] 张国顺,孟冬梅,方正亚,等.HBeAg阳性与阴性乙型肝炎肝硬化患者乙肝病毒载量及肝功能指标的研究[J].中国现代医学杂志,2018,28(16):48-51.
2025, Vol. 42 
