HBV DNA对不同临床分期慢性乙型重型肝炎预后的影响  

Effect of HBV DNA on prognosis of the different clinical stages of chronic severe hepatitis B

作　　者：高洪波[1] 许敏[1] 施海燕[1] 肖蕾[1] 张复春[1] 

机构地区：[1]广州市第八人民医院重症肝病区,510060

出　　处：《实用肝脏病杂志》2010年第2期116-118,共3页Journal of Practical Hepatology

基　　金：广州市医学科研基金资助项目(2008-ZDi-11)

摘　　要：目的探讨慢性乙型重症肝炎早、中、晚期患者HBV DNA对预后的影响。方法统计我院2004～2008年197例不同时期慢性乙型重型肝炎HBV DNA阳性情况,并统计早、中、晚期HBV DNA阳性与阴性组的3个月死亡率,入院2周终末期肝病模型(MELD)分值变化情况。结果早期HBV DNA阳性及阴性组3个月死亡率分别为34%、7.4%(P<0.01);中期分别为48.8%、44.4%(P>0.05);晚期分别为80.0%、76.9%(P>0.05)。早期HBV DNA阳性及阴性组入院2周△MELD值分别为3.6±4.8、0.8±4.1(P=0.01);中期分别为1.5±4.2、1.1±6.5(P>0.05);晚期分别为-1.6±7.3、-1.1±5.8(P>0.05)。结论慢性乙型重型肝炎早期HBV DNA阳性对预后有影响,但中、晚期HBV DNA阳性对预后无影响。Objectives To explore the influence of HBV DNA on prognosis in early,middle and advanced stages of chronic severe hepatitis B patients.Methods To add up the information of HBV DNA in 197 patients in different stages of chronic severe hepatitis B from 2004 to 2008 in our hospital.To measure the three-month mortality of HBV DNA positive group and HBV DNA negative group in early stage,middle stage and advanced stage.To count the changes of model for end-stage liver（MELD） values on two weeks after admission.Results In early stage the three-month mortality of HBV DNA positive group and HBV DNA negative group were 34% and 7.4% respectively（P0.01）.In middle stage and advanced stage the rates of two groups were 48.8% and 44.4%（P 0.05）,80% and 76.9%（P0.05）.In early stage △MELD values on two weeks after admission of HBV DNA positive group and HBV DNA negative group were 3.6±4.8 and 0.8±4.1 respectively（P=0.01）.In middle stage and late stage the values of two groups were 1.5±4.2 and 1.1±6.5（P0.05）,-1.6±7.3 and-1.1±5.8（P0.05）.Conclusions HBV DNA positive influenced the prognosis of chronic severe hepatitis B in early stage,but not in middle stage and advanced stage.

关 键 词：慢性乙型重型肝炎 HBV DNA 预后 终末期肝病模型 

分 类 号：R512.62[医药卫生—内科学]