慢性乙型肝炎患者ALT、HBV DNA及血清肝纤维化标志物与肝纤维化程度的关系  

Correlation of ALT,HBV DNA,and serum markers of fibrosis with liver fibrosis in patients with chronic hepatitis B

作　　者：廖宝林[1] 林思炜 张复春[1] 陈冉[1] 易俊卿[1] 周颖[1] 

机构地区：[1]广州市第八人民医院,广州510060 [2]广州市越秀区中医医院,广州510030

出　　处：《临床肝胆病杂志》2012年第9期657-660,共4页Journal of Clinical Hepatology

摘　　要：目的探讨ALT、HBV DNA以及血清纤维化标志物透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原肽(PⅢP)、Ⅳ型胶原(CⅣ)与慢性乙型肝炎肝纤维化程度的关系。方法检测281例慢性乙型肝炎患者血清中ALT、HBV DNA和纤维化标志物(HA、LN、PⅢP及CⅣ)的水平,并行肝活检检测肝组织病理纤维化分期。结果 HBeAg阴性慢性乙型肝炎患者HBV DNA水平较低、纤维化程度较高。HBeAg阳性患者纤维化程度与HBV DNA呈负相关(r=-0.251,P<0.001),S≥3组水平最低。慢性乙型肝炎患者纤维化程度与PⅢP水平呈正相关,其水平随着纤维化程度的加重而明显升高。结论 PⅢP水平可能作为评估慢性乙型肝炎患者肝纤维化程度的血清学指标,血清HBV DNA与肝脏纤维化严重程度的关系仍需进一步深入探讨。Objective To investigate the relationship between levels of alanine aminotransferase （ ALT）, hepatitis B virus （HBV） DNA, hepatitis B virus e antigen （HBeAg）, and serum fibrosis markers [ （hyaluronic acid （HA）, laminin （LN）, type m procollagen （PⅢP）, and type IV collagen （CⅣ） ] and severity of liver fibrosis in patients with chronic hepatitis B （CHB）. Methods A total of 218 CHB patients were included in this study. Serum levels of ALT were measured by standard biochemical assay. HBV DNA was measured by quantita- tive PCR. Fibrosis markers （HA, LN,PHI P, and CⅣ） were measured by radioimmunoassay. The severity of liver fibrosis was determined by histopathological examination of liver biopsy. Results HBeAg（ - ） CHB patients had a lower level of HBV DNA and a higher level of fi- brosis than HBeAg（ ＋ ） CHB patients. Liver fibrosis in the HBeAg（ ＋ ） CHB patients was negatively correlated with HBV DNA level （ r = -0. 251, P 〈 0. 001 ）, and the lowest Level was found in patients with fibrosis stages ≥3. The severity of liver fibrosis in CHB patients was positively correlated with the serum levels of PⅢP, which conliaed to in severity during progressive development of liver fibrosis.

关 键 词：肝炎 乙型 慢性 肝硬化 丙氨酸转氨酶 DNA 病毒 

分 类 号：R575.2[医药卫生—消化系统]