慢性乙型肝炎患者HBV-DNA水平与肝纤维化程度间相关性分析及意义  

Analysis of Correlation of HBV-DNA with Hepatic Fibrosis and Its Significance in Chronic Hepatitis B Patients.

作　　者：潘红英[1] 谌翠容[1] 张永乐[1] 李冰茹[1] 叶荣夏[1] 卢德荣[1] 娄国强[1] 施军平[1] 

机构地区：[1]杭州市第六人民医院,浙江310014

出　　处：《医学研究杂志》2007年第1期38-40,共3页Journal of Medical Research

基　　金：杭州市科技发展计划项目(2003133B36)

摘　　要：目的深入分析慢性乙型肝炎患者血清、唾液乙肝病毒脱氧核糖核酸(HBV-DNA)含量与肝组织及血清纤维化程度间关系的结果,探讨有关因素的临床意义。方法采用荧光聚合酶链反应(FQ-PCR)精确定量配对检测200例慢性乙型肝炎患者血清、唾液中HBV-DNA含量;按肝组织纤维化程度(S)进行病理分级为0-4级,用放射免疫分析法(RIA)测定患者血清、唾液中层黏蛋白(LN)、透明质酸酶(HA)、IV型胶原(IVC)、前Ⅲ型胶原(PCⅢ)的含量。结果血清、唾液HBV-DNA含量与肝组织纤维化程度均无显著相关性(r=0.09,P=0.22;r=0.05,P=0.52);血清、唾液HBV-DNA含量变化与肝纤维化LN、HA、IVC、PCⅢ指标之间结果分析亦均无明显关系(P均>0.05)。结论HBV-DNA含量与肝组织及血清纤维化程度间无明显相关,其可能原因为:①复杂的病理免疫及发病机制;②病理分级方法学差异;③评价方法的局限性。了解这些因素的存在,能够帮助诊断及选择合理治疗。Objective This study aims at determining significance of analyzing their correlation between HBV - DNA in serum ,saliva and hepatic fibrosis indexes in patients with chronic hepatitis B （ CHB ）. Methods Fluorescence quantitative PCR （ FQ - PCR was applied to precisely determine HBV - DNA in serum and saliva in 200 patients with CHB. Liver biopsy, histological examination were performed, and graded to 0 - 4, depending on pathologist, who were blinded to patients other conditions, granted the hepatic fibro tic scores. Associ- ation of HBV - DNA levels in serum, saliva with hepatic histological grades and liver fibrotic indexes were analyzed. Results Correlative analyses found that no close association of HBV - DNA levels in serum, saliva with histological finding - hepatic fibrosis （S） , or with liver fibrotie sera indexes （ LN, HA, IVC, P3P） as well. Conclusions No significant correlation of HBV - DNA level either with hepatic fibrosis grade or with fibrotic indexes in CHB patients may be attributed to 1. complication of immuno - pathology and pathogenesis of CHB ; 2. application of different methods for hepatic histological grades ; 3. limitation of assessment for these determinants. Comprehensiveness of those factors will help diagnosis and select optimal therapy for CHB.

关 键 词：乙型慢性肝炎 HBV—DNA 肝纤维化 

分 类 号：R512.62[医药卫生—内科学]