慢性乙型病毒性肝炎患者血清HBV DNA水平、血清谷草转氨酶与谷丙转氨酶比值和肝组织病理的关系  

Relationship between serum HBV DNA levels,AST/ALT ratio and liver histology in chronic hepatitis B

作　　者：李仕周[1] 张友祥[2] 

机构地区：[1]湖南省郴州市第一人民医院,湖南郴州423000 [2]上海市公共卫生中心,上海201508

出　　处：《中国医学工程》2006年第5期484-486,共3页China Medical Engineering

摘　　要：目的探讨慢性乙型病毒性肝炎患者HBVDNA水平、血清谷草转氨酶(AST)与谷丙转氨酶(ALT)比值和肝组织病理的关系。方法应用荧光定量聚合酶链反应法(PCR)对211例慢性乙型肝炎患者血清进行HBVDNA定量检测和常规肝功能生化检查,并与同期肝组织活检病理结果对比分析。结果血清HBVDNA水平与肝组织炎症及纤维化无明显相关性(γG=0.361,P>0.05;γS=0.511,P>0.05)。慢性乙型病毒性肝炎患者中活动性肝硬化患者血清AST/ALT比值明显高于正常人及慢性肝炎轻度、中度和重度患者;肝纤维化程度S4期以上的患者血清AST/ALT比值高于S0-S3期的患者,差别均有显著性意义。当血清AST/ALT比值≥1时,诊断早期肝硬化(S4期以上)的灵敏度为85.7%,特异度为84.6%。结论HBVDNA定量与肝组织炎症及纤维化无明显关系。血清AST/ALT比值对肝脏纤维化程度的判断有一定的指导意义。[Objective] To investigate the relationship between serum HBV DNA levels, AST/ALT ratio and liver tissues in patients with chronic hepatitis B. [Methods] Routine biochemical liver function tests and serum HBV DNA level were assayed by amplisensor quantitative polymerase chain reaction in 211 patients; and the liver biopsy was performed and the the grading and staging of the liver were routinely obtained. [Results] There was not obvious correlation between serum HBV DNA level and the grading and staging. The AST/ALT ratio in the cirrhosis group were significantly higher than those in the normal group, mild hepatitis group, and moderate to severe hepatitis group. At the cutoff value of 1 for AST/ALT ratio, the sensitivities were 85.7% and speeifieities were 84.6% for discriminating cirrhosis（fibrosis score： 4）. [Conclusion] There is no Significant correlation between serum HBV DNA and grading ang staging. AST/ALT ratio measurement may be clinically useful as markers of hepatic fibrosis in chronic hepatitis B and cirrhosis.

关 键 词：慢性肝炎 乙型 HBV DNA AST/ALT比值 肝组织病理 

分 类 号：R512.62[医药卫生—内科学]