人工肝和肝移植术后的乙肝三系统定量观察  

Quantitative observation of hepatitis B markers after artificial liver and liver transplantation

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作  者:杨彦麟[1] 公淑芬[2] 肖萍[1] 余水花 陈青锋[1] 赵正斌[4] 岳伟[4] 郭振华[1] 魏喜生[1] 何强[1] 

机构地区:[1]兰州大学第一医院传染病研究室,甘肃兰州730000 [2]兰州大学第一医院药剂科,甘肃兰州730000 [3]甘肃省天水市第二人民医院,741200 [4]兰州大学第一医院传染科,甘肃兰州730000

出  处:《国际检验医学杂志》2009年第4期344-345,348,共3页International Journal of Laboratory Medicine

基  金:甘肃省自然科学基金项目(3ZS061-A25-102)

摘  要:目的观察人工肝技术和肝移植手术对重症乙肝患者乙肝病毒标志物的影响。方法乙肝三系统定量采用时间分辨免疫荧光技术,乙肝病毒DNA定量采用实时荧光定量PCR法。结果28例实施人工肝技术的重型肝炎患者治疗前后的乙肝三系统定量和HBVDNA定量结果为:HBsAg171.19±32.10ng/mL,HBeAg0.03±0.029NCU/mL,抗-HBe3.97±4.61NCU/mL,抗-HBc5.98±3.31NCU/mL,HBVDNA(1.1×10^7)±(6.81×10^6)copy/mL和HBsAg168.14±39.40ng/mL,HBeAg0.02±0.023NCU/mL,抗-HBe3.95±4.34NCU/mL,抗-HBc6.41±3.13NCU/mL,HBVDNA(1.1×10^7)±(6.23×10^6)copy/mL。P值均大于0.05,差异无统计学意义。26例施行肝移植手术的患者治疗前后的乙肝三系统定量和HBVDNA定量结果分别为HBsAg144.65±77.00ng/mL,HBeAg0.02±0.028NCU/mL,抗-HBe4.32±6.43NCU/mL,抗-HBc6.04±4.88NCU/mL,HBV DNA(1.0×10^7)±(6.89×10^6)copy/mL和HBsAg6.54±3.32ng/mL,HBeAg0.02±0.016NCU/mL,抗-HBe4.79±6.44NCU/mL,抗-HBc5.97±4.64NCU/mL,HBV DNA(1.04×10^2)±(3.40×10^2)copy/mL。除抗-HBe和抗-HBc,P值大于0.05外,其他项目P值均小于0.05,差异有统计学意义。结论肝移植手术可有效清除乙肝患者体内的乙肝病毒,人工肝支持系统虽不能有效清除乙肝患者体内的乙肝病毒,但可改善重型肝炎患者体内严重紊乱的内环境,为肝移植手术创造合适的条件和机会,赢得宝贵时间。Objective To observe the effect of artificial liver technique and liver transplantation operation on hepatitis B markers (HBV M) of patients with severe chronic hepatitis B (SCH). Methods Time-resolved quantitative immunofluorescence technology was applied to quantitatively measuring hepatitis B markers,and real-time fluorescent PCR was adopted to quantitatively detect HBV DNA. Results The test results of HBV M and HBV DNA quantitation after and before artificial liver treatment in 28 cases of SCH were as follows: HBsAg (ng/mL) 168. 14 ± 39. 40 vs 171. 19 ± 32. 10; HBeAg (NCU/mL) 0. 020±0. 023 vs 0. 030±0. 029; anti-HBe (NCU/mL) 3.95±4.34 vs 3.97± 4.61; anti-HBc (NCU/mL) 6.41 ±3.13 vs 5.98± 3.31; HBV DNA (copy/mL) 1.1× 10^7 ±6.23× 10^6 vs 1.1 × 10^7 ±6.81 × 106. There were no significant differences in HBV M and HBV DNA between after and before artificial liver treatment groups (P〉0.05). The test results of HBV M and HBV DNA quantitation after and before liver transplant operation in 26 cases of SCH were as follows: HBsag (ng/mL) 6.54±3. 321 vs 144.65±77.00; HBeAg (NCU/mL) 0. 020±0. 016 vs 0. 020±0. 028; anti-HBe (NCU/mL) 4.79±6.44 vs 4.32±6.43;anti-HBc (NCU/mL) 5.97±4.64 vs 6. 04±4.88; HBV DNA (copy/mL) 1.04 × 10^2 ± 3. 40 × 10^2 vs 1. 0 × 10^7 ± 6. 89 × 10^6. There were significant differences in HBsAg, HBeAg and HBV DNA between after and before liver transplant operation groups (P〈0.05). Conclusion Liver transplant operation effectively eliminates HBV in vivo. Artificial liver treatment can not eliminate HBV in patients, but it may ameliorate the disordered internal environment of SCH patients,and provide the patients an opportunity of liver transplant operation.

关 键 词:肝炎 乙型  人工 肝移植 临床实验室技术 

分 类 号:R446.61[医药卫生—诊断学] R512.62[医药卫生—临床医学]

 

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