目的 血清乙型肝炎表面抗原（qHBsAg）定量水平已被评价为在慢性乙型肝炎患者组中作 为肝组织学纤维化的标志。但研究对象很少是 HBeAg 阴性慢性 HBV 患者，本研究的目的是评估 qHBsAg 定量水平在未经治疗的 HBeAg 阴性慢性乙肝患者的肝纤维化分期中是否有诊断价值。方法 回顾性分 析患者 HBsAg 定量水平与 HBV DNA、丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、肝纤维化等 指标的关系。在基线时测量 HBsAg 水平作为单点定量，评估的 qHBsAg 临界点为 1 000 IU/mL，以证明它是 否能很好的区分轻度纤维化（S0⁃1）和显著纤维化（S2⁃4）患者。结果 qHBsAg 水平> 1 000 IU/mL 与 qHB⁃ sAg 水平＜1 000 IU/mL 相比，qHBsAg 水平> 1 000 IU/mL 的患者更有可能发生 S2⁃4 纤维化（P = 0.029），差异具有统计学意义。但在不同纤维化分期中，发生 S0⁃1（3.53 ± 0.15）和 S2⁃4 纤维化（3.62 ± 0.16，P = 0.07） 患者的 qHBsAg 差异并无统计学意义。当 HBV DNA（> 2 000 IU/mL）联合 HBsAg 临界值评估不同肝纤维化 分期时，出现显著纤维化（S2⁃4）的发生率与 qHBsAg 水平无明显的相关性。血清 qHBsAg 不能准确鉴定纤 维化分期（AUROC，0.62，cut⁃off 值为 3 758 IU/mL ，敏感性为 73.1%，特异性 54.2%）。结论 血清 HBsAg 水 平不能区分具有显著纤维化（S2⁃4）的患者。超过一半的无显著纤维化患者的qHBsAg 水平> 1 000 IU/mL

Objective The quantitative level of serum hepatitis B surface antigen（qHBsAg）has been evaluated as a marker of liver histological fibrosis in the chronic hepatitis B patient group. However ，few study focuses on HBeAg ⁃negative chronic HBV patients. The purpose of this study is to assess whether the quantitative level of qHBsAg has diagnostic value in staging of liver fibrosis in untreated HBeAg⁃negative chronic HBV patients. Methods The relationships between the quantitative levels of HBsAg and HBV DNA，alanine aminotransferase （ALT），aspartate aminotransferase（AST），liver fibrosis and other indicators were retrospectively analyzed. The HBsAg levels were measured at baseline as a single point of quantification and the cut⁃off point for the evaluated qHBsAg was 1 000 IU/mL. It was used to prove whether it could distinguish patients with mild fibrosis（S0⁃1）from significant fibrosis（S2⁃4）. Results Compared with patients with qHBsAg level < 1 000 IU/mL，patients with qHBsAg level > 1 000 IU/mL are more likely to develop S2⁃4 fibrosis（P = 0.029）and the difference is statistically significant. However，there was no significant difference in qHBsAg in patients with S0⁃1（3.53 ± 0.15）and S2⁃4 fibrosis（3.62 ± 0.16，P = 0.07）in different fibrosis stages. When HBV DNA（> 2 000 IU/mL）combined with HBsAg cut⁃off valueto evaluate different liver fibrosis stages，the incidence of significant fibrosis（S2⁃4）has no obvious correlation with qHBsAg level. qHBsAg could not accurately identify the stage of fibrosis（AUROC，0.62， cut ⁃ off value of 3 758 IU/mL，sensitivity of 73.1% ，specificity of 54.2%）. Conclusion Serum HBsAg levels could not distinguish patients with significant fibrosis（S2⁃4）. In addition，more than half of patients with no signif⁃