广州市慢性乙型肝炎患者表面抗原水平分析  

Analysis of hepatitis B surface antigen levels in patients with chronic hepatitis B in Guangzhou

作　　者：曾磊[1] 丁爱娇 江凌晓[1] 曾静[1] 林裕龙[1] 袁小澎[1] 

机构地区：[1]南方医科大学珠江医院检验医学部,广东广州510282

出　　处：《南方医科大学学报》2014年第7期974-977,共4页Journal of Southern Medical University

基　　金：国家自然科学基金(30972788);雅培病毒性肝炎诊疗课题~~

摘　　要：目的对广州市慢性乙型肝炎患者不同感染阶段表面抗原(HBsAg)水平进行定量检测,并结合乙型肝炎病毒DNA(HBVDNA)等检测结果探讨HBsAg定量在慢性乙型肝炎患者诊断和治疗监测的临床意义。方法按照美国肝病学会慢性乙型肝炎分期规则标准将其分为免疫耐受期(IT)、e抗原阳性的慢性肝炎期(EPH)、非活动性携带期(IC)、e抗原阴性的慢性乙型肝炎期(ENH)。将珠江医院就诊的慢性乙型肝炎患者96例按要求分期,对其血清样本进行HBsAg、HBV-DNA和ALT检测,并对结果进行统计分析。结果广州市慢性乙型肝炎感染过程不同阶段HBsAg均值分别为:IT(4.12 log10U/L)、EPH(4.02 log10U/L)、IC(2.85 log10U/L)、ENH(3.29 log10U/L),差异显著。IT、IC、EPH、ENH期患者HBsAg水平与HBV-DNA拷贝数的相关系数分别是0.6828、0.5759、0.3280、0.1083,相关性逐步减弱。HBeAg(+)患者HBsAg定量水平明显高于HBeAg(-)患者。各期HBsAg的量与ALT水平均无相关性。结论不同感染阶段的慢性乙型肝炎患者HBsAg定量水平存在差异,HBsAg水平与HBV-DNA的不完全一致性表明HBsAg定量可以作为新的检测指标在诊断和治疗监测中发挥作用,更多的检测手段将有助于临床慢性乙型肝炎患者的个体化分类和治疗。Objective To assess the value of quantitative analysis of hepatitis B surface antigen （HBsAg） levels in the diagnosis and therapeutic evaluations in patients with chronic hepatitis B （CHB）. Methods According to the staging criteria defined by the American Association of Liver Diseases, 96 patients with CHB admitted in Zhujiang Hospital were classified in immune-tolerant （IT）, HBeAg-positive hepatitis （EPH）, inactive carrier （IC） and HBeAg-negative hepatitis （ENH） phases. Serum HBsAg, HBV-DNA and ALT levels were quantified and their correlations were evaluated in each phase of infection. Results The mean HBsAg titers （measured in log10U/L） differed significantly between the phases of CHB （4.12 in IT, 4.02 in EPH, 2.85 in EPH, and 3.29 in ENH）. The correlation coefficient of HBsAg with HBV-DNA was 0.6828 in IT, 0.5759 in EPH, 0.3280 in IC, and 0.1083 in ENH. Serum HBsAg titers were significantly higher in HBeAg-positive patients than in HBeAg-negative patients. No correlation was found between HBsAg level and ALT in each phase of CHB. Conclusion The median baseline serum HBsAg levels vary between different phases of CHB in Guangzhou, suggesting the value of HBsAg in accurate classification of hepatitis B patients and evaluation of the therapeutic effect and outcomes of the patients.

关 键 词：慢性乙型肝炎 表面抗原定量 乙型肝炎病毒DNA 

分 类 号：R512.62[医药卫生—内科学]