乙型肝炎血清学与肝组织病理学之间关系的探讨  

Relationship between serology and liver pathology of patients

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

机构地区：[1]浙江中医药大学附属杭州六院杭州市第六人民医院,杭州310014

出　　处：《中国卫生检验杂志》2009年第9期2067-2068,2078,共3页Chinese Journal of Health Laboratory Technology

基　　金：杭州市科技发展计划项目(2003133B36)

摘　　要：目的:探讨乙型肝炎血清HBV DNA、HBeAg、肝内HBcAg以及肝组织病理分级分期的关系。方法:对200例乙性肝炎患者的血清进行荧光定量PCR检测和血清HBeAg检测,同时采用肝活组织病理检测,利用免疫组织化学方法测定肝内HBcAg存在情况,进而分析相关性。结果:200例乙型肝炎血清HBVDNA>2×104IU/ml有157例(78.5%),血清HBeAg阳性108例(54%),肝内HBcAg阳性169例(84.5),肝组织炎症活动分级G026例、G168例、G236例、G346例、G424例,肝组织纤维化分期S039例、S059例、S036例、S040例、S026例。结论:慢性乙型肝炎肝内HBcAg表达要较血清HBVDNA和血清HBeAg表达更能准确反映肝细胞内HBV复制状态。检测肝内HBcAg对乙肝患者抗病毒疗效评价以及预后评估更有临床意义。血清学指标与肝组织病理分级分期未见相关性。Objective：To investigate the relationship between HBVDNA, HBeAg in the serum, HBcAg in the liver and the classification and staging of liver pathology of the patients. Methods：The serum from 200 patients was measured by fluorescence quantitative PCR and HBeAg detection. Meanwhile, the liver biopsies pathological examination was performed, and the existence of HBcAg in the liver was detected by immunohistochemical method, aiming at analyzing their correlations. Results：In the 200 cases, 157 （78.5%） with HBVDNA over2 × 10^4 IU/ml, 108 （54%） with serum HBeAg positivity, 169 （84. 5% ） with liver HB- cAg positivity. 26, 68, 36, 46 and 24 with classification of liver inflammation of G0, G1 , G2 , G3 and G4, respectively, and 39, 59, 36, 40, 26 with the staging of liver tissue fibrosis of S0, S1 , S2 , S3 , S4, respectively. Conclusion：Expression of liver HB- cAg is more accurate than serum HBVDNA and HBeAg to reflect the replication status in the liver cells. Detection of liver HBcAg will be more clinical significance both for the antiviral effect assessment and the prognostic evaluation. There is no relationship between the serum index and the classification, staging of liver pathology.

关 键 词：乙型肝炎 肝组织病理 乙肝核心抗原 HBVDNA 

分 类 号：R512.62[医药卫生—内科学]