慢性乙型肝炎、肝硬化患者肝组织病毒载量与肝组织损伤程度的关系  

The correlations between HBV quantity in the liver tissue and the severity of liver tissue injury in chronic hepatitis B and hepatic cirrhosis

作　　者：牛春燕[1] 高保华[1] 郑建云[2] 吴方雄 汪雯[1] 罗建梅[3] 郑乃青 

机构地区：[1]西安医学院附属医院消化内科,西安710077 [2]西安医学院附属医院病理科,西安710077 [3]西安医学院附属医院超声医学科,西安710077 [4]西安医学院附属医院检验科,西安710077

出　　处：《临床肝胆病杂志》2011年第3期277-279,共3页Journal of Clinical Hepatology

摘　　要：目的了解慢性乙型肝炎(CHB)、肝硬化患者肝内HBV载量的变化与肝组织损伤程度的关系及其对该类患者的预后意义。方法经血清学及肝穿刺病理组织学证实为CHB 46例,经血清学及影像学确诊、手术获得的肝硬化标本17例。采用实时荧光载量系统检测血清及肝组织HBV DNA载量,并观察肝组织炎症及纤维化程度。结果 (1)肝硬化组血清HBV DNA载量低于HBeAg阳性CHB组(P<0.01)、高于HBeAg阴性CHB组(P<0.001);肝硬化组肝组织HBV DNA载量低于HBeAg阳性及HBeAg阴性CHB组(P<0.001、P<0.01);HBeAg阳性及阴性CHB组的肝组织HBV DNA载量均高于血清HBV DNA载量(P<0.05、P<0.01),肝硬化组肝组织HBV DNA载量低于血清(P<0.001)。(2)CHB、肝硬化血清HBV DNA载量与肝组织的炎症及纤维化程度呈正相关(P<0.05),肝组织HBV DNA载量则与肝组织的炎症及纤维化程度呈明显负相关(P<0.05)。结论肝组织HBV DNA较血清HBV DNA载量更能准确反映肝内HBV复制水平、肝组织损伤程度以及CHB、CHB肝硬化的进展程度。Objective To understand the correlations between HBV quantity in the liver tissue and severity of hepatic injury in chronic hepatitis B and hepatic cirrhosis.Methods This study included 46 CHB patients and 17 hepatic cirrhosis patients and they were divided into two groups according to HBeAg positive and HBeAg negative.Specimens of all the patients were obtained by liver biopsy or surgery and histology examinations were performed.Intrahepatic HBV DNA and serum HBV DNA quantity were detected by Realtime-PCR.Results（1）Serum HBV DNA quantity of liver cirrhosis group was lower than that of HBeAg（＋） CHB group（P0.01）,but higher than that of HBeAg（-） CHB group（P0.001）.Intrahepatic HBV DNA quantity of liver cirrhosis group was lower than that of HBeAg（＋） and HBeAg（-） CHB groups（P0.001 and P0.01 respectively）.Intrahepatic HBV DNA quantity was higher than that of serum HBV DNA in both CHB groups（P0.05 and P0.01 respectively）,while intrahepatic HBV DNA quantity was lower than that of the serum HBV DNA in the liver cirrhosis group（P0.001）.（2）Serum HBV DNA quantity was positively related to hepatic inflammation degree and fibrosis stage（P0.05）,while intrahepatic HBV DNA quantity was negatively related to hepatic inflammation grade and fibrosis stage（P0.05）.Conclusion Comparing with serum HBV DNA,intrahepatic HBV DNA quantity can reflect much accurately on HBV amplification in the liver,severity of tissue injury and hepatology progression.

关 键 词：肝炎 乙型 慢性 肝硬化 肝炎病毒 乙型 病毒载量 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学]