中文摘要：

目的探讨HBsAg水平在慢性HBV感染者疾病进展监测中的临床价值。方法收集2011年5月-2015年12月在安徽医科大学第二附属医院门诊及住院时未进行抗病毒治疗的1107例不同临床阶段的慢性HBV感染者的临床资料,并根据疾病状态分为HBeAg阳性慢性乙型肝炎组（HBeAg阳性CHB组,n=356）、HBeAg阴性慢性乙型肝炎组（HBeAg阴性CHB组,n=264）、乙型肝炎肝硬化代偿期组（LC-C组,n=116）、乙型肝炎肝硬化失代偿期组（LC-D组,n=201）、原发性肝癌组（PLC组,n=170）,比较不同临床阶段患者之间HBsAg表达水平的差异及HBsAg水平与临床特征的相关性。计量资料多组间比较采用方差分析,进一步两两比较采用LSD-t检验;两组间比较采用t检验。计数资料组间比较采用χ2检验。相关性分析采用Pearson检验。结果HBeAg阳性CHB组、HBeAg阴性CHB组、LC-C组、LC-D组、PLC组之间患者血清HBsAg、HBV DNA水平比较,差异均有统计学意义（F值分别为100.45、86.26,P值均〈0.001）。502例HBeAg阳性患者的HBsAg、HBV DNA水平均高于605例HBeAg阴性患者（t值分别为16.67、16.22,P值均〈0.001）。HBeAg阳性值均CHB、LC-C、LC-D和PLC 4组间HBsAg和HBV DNA水平差异均有统计学意义（F值分别为42.92、27.38,P值均〈0.001）;HBeAg阴性的CHB、LC-C、LC-D和PLC 4组间的HBsAg和HBV DNA水平差异亦均有统计学意义（F值分别为6.04、4.10,P值均〈0.05）。不同HBsAg水平（〈1000 IU/ml、1000~20 000 IU/ml、〉20 000 IU/ml）患者间HBV DNA水平差异有统计学意义（F=189.51,P〈0.001）。HBeAg阳性CHB组、HBeAg阴性CHB组、LC-C组、LC-D组患者血清HBsAg水平与HBV DNA水平均呈正相关（r值分别为0.554、0.501、0.320、0.432,P值均〈0.001）。结论 HBsAg定量水平随疾病进展而逐步降低,且HBsAg与HBV DNA水平密切相关,动态监测HBsAg变化有助于发现HBV感染后疾病进展情况。

英文摘要：

Objective To investigate the clinical value of HBsAg level in dynamic monitoring of disease progression in patients with chronic HBV infection. Methods A retrospective analysis was performed for the clinical data of 1107 patients with different clinical stages of chron-ic HBV infection who had not received antiviral therapy at the time of hospitalization in The Second Affiliated Hospital of Anhui Medical Uni-versity from May 2011 to December 2015, and according to the disease status, they were divided into HBeAg - positive chronic hepatitis B （CUB） group （ n = 356） , HBeAg - negative CHB group （ n = 264） , compensated liver cirrhosis group （ LC - C group = 1 1 6 ） , decompen-sated liver cirrhosis group （ LC - D group ,n = 201 ） , and primary liver cancer （ PLC ） group （n = 170 ） . These groups were compared in terms of HBsAg expression and the association between HBsAg and clinical features. An analysis of variance was used for comparison of con-tinuous data between multiple groups, and the least significant difference t - test was used for further comparison between any two groups ; the t - test was used for comparison of continuous data between two groups. The chi - square test was used for comparison of categorical data be-tween these groups. Pearson correlation analysis was also performed. Results There were significant differences in serum HBsAg and HBV DNA level between the HBeAg - positive CHB group, HBeAg - negative CHB group, LC - C group, LC - D group, and PLC group （F = 100. 45 and 86. 2 6 , both P 〈0. 001） . The HBeAg - positive CHB group（ ft = 502） had significantly higher levels of HBsAg and HBV DNA than the HBeAg - negative CHB group （n = 605） （ t = 16. 67 and 16. 2 2 , both P 〈 0. 001） . There were significant differences in HBsAg and HBV DNA levels between the HBeAg - positive CHB group, LC - C group, LC - D group, and PLC group （F =