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

doi:10.3969/j.issn.1671-7171.2025.02.027

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摘要【目的】探讨T淋巴细胞亚群、乙型肝炎表面抗原(HBsAg)、乙型肝炎e抗原(HBeAg)评估乙肝患者不同病理状态的临床价值。【方法】选择2020年5月至2023年5月本中心收治的85例乙肝患者,病理学检查结果显示,炎症分级＜2级48例、炎症分级≥2级37例,纤维化分期＜2期36例、纤维化分期≥2期49例。比较不同纤维化分期及炎症分级的乙肝患者HBsAg、HBeAg、T淋巴细胞亚群水平,采用受试者工作特征(ROC)曲线分析HBsAg、HBeAg及T淋巴细胞亚群水平评估乙肝患者不同病理状态的临床价值。【结果】纤维化分期≥2期的患者HBsAg、HBeAg水平明显低于纤维化分期＜2期的患者,差异有统计学意义(P<0.05);不同纤维化分期的乙肝患者CD4⁺、CD8⁺水平比较,差异无统计学意义(P>0.05)。ROC曲线分析显示,HBsAg、HBeAg水平预测纤维化分期≥2期的临床效能较好,曲线下面积分别为0.772、0.821(P<0.05)。炎症分级≥2级的患者HBsAg、HBeAg、CD8⁺水平明显低于炎症分级＜2级的患者,CD4⁺水平明显高于炎症分级＜2级的患者,差异有统计学意义(P<0.05)。ROC曲线分析显示,HBsAg、HBeAg、CD4⁺、CD8⁺水平预测炎症分级≥2级的临床效能较好,曲线下面积为0.785、0.808、0.644、0.683,差异有统计学意义(P<0.05)。【结论】不同病理状态下乙肝患者的HBsAg、HBeAg水平及免疫功能存在异常,临床可联合检测HBsAg、HBeAg及T淋巴细胞亚群水平,可更好地评估患者疾病进展情况。

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关键词 ：乙型肝炎, T淋巴细胞亚群, 乙型肝炎表面抗原, 乙型肝炎e抗原

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.

Key words： Hepatitis B T-Lymphocyte Subsets Hepatitis B Surface Antigens Hepatitis B e Antigens

收稿日期: 2023-11-21

中图分类号:

R512.62

通讯作者: *E-mail:13524678789@163.com

引用本文:

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.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2025.02.027 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2025/V42/I2/268

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