HBsAg及HBVDNA定量水平在慢性乙型肝炎、肝硬化和肝癌患者中的变化  

The discrepancy of HBsAg titre and HBV DNA in patients with chronic hepatitis B, HBV-related liver cirrhosis and hepatocellular carcinoma

作　　者：裴彦祯[1] 韩涛[2] 马晓艳[1] 李莹[1] 邢晶[1] 宋佐莉[3] 

机构地区：[1]天津医科大学三中心临床学院肝内科,300170 [2]天津市肝胆疾病研究所天津市人工细胞重点实验室 [3]天津市第三中心医院检验科

出　　处：《中华肝脏病杂志》2011年第10期743-746,共4页Chinese Journal of Hepatology

基　　金：国家重点基础研究发展规划基金资助项目（2007CB512801）;“十一五”科技重大专项（2008ZX10002-005）;天津市卫生局重点攻关资助项目（07KG9）

摘　　要：目的 了解HBsAg定量水平在慢性乙型肝炎、乙型肝炎肝硬化、HBsAg阳性的原发性肝癌患者中的变化及其在3组患者中与HBVDNA的相关性。方法采集47例慢性乙型肝炎患者（乙型肝炎组），72例乙型肝炎肝硬化患者（肝硬化组）及54例肝癌患者（肝癌组）的血清标本，用雅培化学发光法进行HBsAg定量测定，荧光PCR定量法检测HBVDNA量水平。多组分析采用KruskalWallis检验，两组间比较采用Mann-WhitneyU检验，相关胜分析采用Spearman检验。结果HBsAg定量值在乙型肝炎、肝硬化、肝癌组患者中的中位数分别为2361．10、1001．64、594．35IU／nfl，3组间呈逐渐下降趋势，X^2=24．394，P〈0．05，差异有统计学意义；乙型肝炎组与肝硬化组比较，z=-3．754，P〈0．05，差异有统计学意义；乙型肝炎组与肝癌组比较，Z=-4．630，P〈0．05，差异有统计学意义；而肝硬化组与肝癌组比较，差异无统计学意义。HBeAg阳性患者，HBsAg定量值在乙型肝炎组、肝硬化组、肝癌组患者的中位数分别为3259．83、1077．30、789．72IU／ml，3组间呈下降趋势，x^2=15．643，P〈0．01，差异有统计学意义。对于HBeAg阴性患者，HBsAg定量值在乙型肝炎组、肝硬化组、肝癌组患者的中位数分别为1669．00、1001．64、582．05IU／ml，3组间呈下降趋势，x^2=6．423，P〈0．05，差异有统计学意义。HBVDNA定量值在乙型肝炎组、肝硬化组、肝癌组患者的中位数分别为5．3579、4．2207、1．0000log10拷贝／ml，4分位数间距分别为（4．3579～6．8745）、（0．0000～5．7393）、（0．0000～4．6651）log10拷贝／ml，3组HBVDNA定量值比较，x^2=31．412，P〈0．05，差异有统计学意义；HBsAg与HBVDNA在乙型肝炎组（r=0．297，P〈0．05）、肝硬化组（r=0．346，P〈0．05）、肝癌组（r=0．452，P〈0．05）均呈正相关。结论HBsAg定量值在慢性乙型肝炎、肝硬化、肝癌患者Objective To investigate the discrepancy ofHBsAg titre and correlation ofHBV DNA levels among patients with chronic hepatitis B （CHB）, HBV-related liver cirrhosis （LC） and hepatocellular carcinoma （HCC）. Methods tlBsAg titre and ttBV DNA in serum samples were measured among 47 CHB, 72 LC and 54 HCC cases using Abbott chemiluminescence and fluorescence quantitative PCR, respectively. Statistical analyses among multiple groups, between two groups and about the correlation were pertormed using Kruskal-Wallis test, Mann-Whimey U test and Spearman test, respectively. Results The median HBsAg titre level in serum samples decreased from 2361.10 IU/ml in CHB cohort to 1001.64 IU/ml in LC cohort and 594.35 IU/ml in HCC cohort, suggesting a statistically significant difference （x2 = 24.394,P 〈 0.05）. Moreover, HBsAg titre in CHB group was significantly higher than that in LC group （Z = -3.754, P 〈 0.05）. CHB patients had significantly higher HBsAg titre than HCC cases （Z = -4.630,P 〈 0.05）. However, there was no statistically significant difference in HBsAg titre between LC and HCC group. Among HBeAg positive patients, HBsAg titre decreased from 3259.83 IU/ml in CHB group to 1077.30 IU/ml in LC group and 789.72 1U/ml in HCC group, indicating a significant difference （x2 = 15.643, P 〈 0.01）. Among HBeAg negative patients, HBsAg titre declined from 1669.00 IU/ml in CHB group to 1001.64 1U/ml in LC group and 582.05 IU/ml in HCC group, suggesting of a significant difference （x2 = 6.423, P 〈 0.05）. Positive correlation between HBsAg titre and HBV DNA was found in CHB （r = 0.297, P 〈 0.05）, LC（r = 0.346, P 〈 0.05） and HCC（r = 0.452, P 〈 0.05）, respectively. Conclusion HBsAg titre level in serum decreased progressively from CI-IB to LC and HCC group. There were positive correlations between HBsAg titre and HBV DNA level in CHB, LC and HCC.

关 键 词：肝炎抗原 乙型 肝炎病毒 乙型 肝炎 乙型 慢胜 肝硬化 肝细胞癌 

分 类 号：R512.62[医药卫生—内科学]