慢性乙型肝炎血清病毒载量水平与肝硬化的关系  

Correlation between HBV-DNA and progress to cirrhosis in patients with chronic hepatitis B

作　　者：刘黎黎[1] 王吉耀[1] 余为民[1] 

机构地区：[1]复旦大学附属中山医院消化科,上海200032

出　　处：《中华消化杂志》2008年第11期742-745,共4页Chinese Journal of Digestion

摘　　要：目的探讨慢性乙型肝炎患者病程中血清乙型肝炎病毒（HBV）-DNA水平的变化与肝硬化发生的关系。方法收集2001至2007年经肝穿刺确诊的239例慢性乙型肝炎患者，中位随访时间28个月，检测入选和随访终点的血清HBV-DNA水平，观察肝硬化发生情况。结果发生肝硬化者较无肝硬化者年龄更大，随访终点HBV—DNA水平更高，但两组入选时HBV-DNA水平差异无统计学意义（P=0．531）。Kaplan—Meier法生存分析显示，随访终点HBV-DNA水平越高，发生肝硬化比例亦越高（X^2=11．736，P=0．019）。Cox比例风险模型显示，随访终点HBV—DNA水平、入选时的肝组织纤维化分期、乙型肝炎病毒e抗原阴性和γ-谷氨酰转肽酶水平为预示肝硬化发生的危险因素，风险比分别为1．898、1．918、8．976、1．006。结论随访终点HBV-DNA和慢性乙型肝炎肝硬化的发生密切相关。Objective To investigate the relationship between HBV-DNA level during the course and progress to cirrhosis in patients with chronic hepatitis B. Methods From 2001 to 2007, a total of 239 chronic hepatitis B patients confirmed by liver biopsy were followed up for a median time of 28 months. HBV-DNA level was measured at baseline and end point. Results Those who progressed to cirrhosis were older and with higher HBV-DNA levels at the end point. Kaplan-Meier analysis showed that the higher the HBV-DNA level at end point, the higher the risk to cirrhosis （X^2 = 11. 736,P=0. 019）. There was no difference between patients with and without cirrhosis at baseline of HBV-DNA level （P= 0. 531）. The Cox regression indicated that the independent risk factors of cirrhosis were as followings： HBV-DNA level at the end point, stage of fibrosis, hepatitis B e antigen negative and γ-glutamyl transpeptidase at entry with relative risk ratio of 1. 898, 1. 918, 8. 976 and 1. 006, respectively. Coneluslon HBV-DNA level is correlated with progress to cirrhosis in patients with chronic hepatitis B.

关 键 词：乙型肝炎 慢性 病毒载量 纤维化 

分 类 号：R686[医药卫生—骨科学]