关键词: 慢性乙型肝炎, HBeAg, 拉米夫定, YMDD变异, 肝硬化

Abstract: Objective To evaluate the diversity of biochemical virological indicator and the different clinical prognosis between HBeAg-positive and HBeAg-negative chronic hepatitis B group（CHB） patients with the long term therapy of lamivudine. Methods Sixty-three patients with chronic hepatitis B were treated with lamivudine,100mg/d and observed for three years. The serum HBV markers,HBV DNA,ALT,AFP and other biochemical indicators were detected. Results In the HBeAg-positive therapy group,the ratio of ALT normalization,the ratio of HBV DNA negative conversion,the incidence rate of hepatocellular carcinoma and the ratio of HBsAg negative conversion were 64.7%,64.7%,0%,0% after three years respectively;In the HBeAg-negative therapy group,these rates were 70.4%,77.8%,0%,0% respectively. There was no significant difference between the two groups. The ratio of YMDD mutation of HBeAg-positive patients was 43.3%,which was significantly higher than that（18.2%） in HBeAg-negative,x²=4.720,P<0.05. The proportion of patients with liver cirrhosis in HBeAg-negative group（37.0%） was higher than that in HBeAg-positive group（5.9%）,x²=3.866,P<0.05. Conclusion The patients with HBeAg-positive is more susceptible to YMDD mutation than HBeAg-negative patients;HBeAg-negative patients is more susceptible to liver cirrhosis than HBeAg-positive patients in the treatment of lamivudine.

Key words: Chronic hepatitis B, Hepatitis B e antigens, Lamivudine, YMDD mutation, Liver Cirrhosis