失代偿期乙肝肝硬化患者血清HBVDNA水平与临床特征及48周短期转归关系  

The relationship between the levels of HBV DNA loads and both the clinical characteristics and 48-week prognosis in patients with decompensated cirrhosis due to hepatitis B

作　　者：徐启桓[1] 揭育胜[1] 林淑珍[2] 舒欣[1] 陈旎[1] 谢奇峰[1] 李刚[1] 

机构地区：[1]广州中山大学附属第三医院感染科,510630 [2]广东省东莞市厚街医院感染科

出　　处：《中华实验和临床病毒学杂志》2009年第4期282-284,共3页Chinese Journal of Experimental and Clinical Virology

基　　金：国家十一五计划“艾滋病和病毒性肝炎等重大传染病防治科技重大专项”（2008ZX10002-005）

摘　　要：目的观察失代偿期乙肝肝硬化患者血清HBVDNA载量水平与临床特征及48周临床转归的关系。方法143例患者Child—Pugh评分、基础情况相当，分为低病毒载量组46例和高病毒载量97例。两组病例均给予常规对症支持治疗，低病毒载量组21例、高病毒载量组52例，在常规治疗基础上根据患者的经济情况及意愿给予核苷类似物抗病毒治疗。结果观察前两组患者人口学及基线ALT、ALB、TBil、CHE等方面比较，差异均无统计学意义（P〉0．05），在AST、HBeAg阳性率方面比较，差异均有统计学意义（P〈0．05）。低病毒载量组与高病毒载量组比较，48周血清AST、ALT、TBiL、ALB、CHE差异均无统计学意义（P〉0．05）。两组死亡率相近，而低病毒载量组原发性肝癌、自发性腹膜炎及消化道出血等均高于高病毒载量组。结论失代偿期乙肝肝硬化患者病情并不随着病毒载量的下降而缓解，低病毒载量患者也应当重视早期治疗。Objective To evaluate the relationship between the levels of HBV DNA loads and both the clinical characteristics and 48-week prognosis in patients with decompensated cirrhosis due to hepatitis B. Methods One hundred and forty-three patients with decompensated cirrhosis of hepatitis B virus infection were divided into lowlevel HBV DNA group [ HBV DNA 〈 10^5 copies/ml = （46 cases） and high-level HBV-DNA group（HBV DNA ≥ 105 copies/ml）（97 cases）]. 21 cases in low-level group and 52 cases in high-level group treated with nucleoside analog. Results There was no significant difference between the two groups on the demography and the baseline in ALT,ALB ,TBil,CHE before treatment, while in AST and HBeAg were statistically different. At 48-week, there was no significant difference between the two groups on the liver function. The mortality rate in low-level group was similar to that in high level group. In the low-level HBV DNA patients, hepatocellular carcinoma, spontaneous peritonitis and gastrointestinal hemorrhage were higer than that in the high-level HBV DNA patients. Conclusion In patients with decompensated cirrhosis due to hepatitis B, those who were in low-level HBV DNA had not got better than that in high-level HBV DNA, which indicated that earlier treatment was also needed in low-level HBV DNA patients.

关 键 词：肝炎病毒 乙型 肝硬化 DNA 病毒载量 

分 类 号：R512.6[医药卫生—内科学] R575.2[医药卫生—临床医学] R450