病毒载量对不同病变阶段慢性乙型肝炎患者红细胞参数的影响及其临床意义  

Effects and clinical significance of virus load on red blood cell parameters in different stage of hepatitis B

作　　者：高鹏[1] 肖萍[1] 杨彦麟[1] 陈青锋[1] 毛小荣[2] 赵正斌[2] 石磊[3] 杨李忠 周伟[1] 

机构地区：[1]兰州大学第一医院传染病研究室 [2]兰州大学第一医院传染科 [3]兰州大学第二医院检验科,兰州730000 [4]泾川县人民医院检验科,甘肃泾川744300

出　　处：《北京大学学报（医学版）》2014年第6期941-944,共4页Journal of Peking University:Health Sciences

摘　　要：目的:探讨不同病毒载量对慢性乙型肝炎患者红细胞参数的影响及其临床意义。方法:选取兰州大学第一医院确诊为慢性乙型肝炎的患者373例,其中丙氨酸转移酶(alanine transaminase,ALT)正常的慢性乙型肝炎患者123例(ALT<40 U/L),ALT大于等于正常上限、且小于2倍增高的慢性乙型肝炎患者128例(40U/L≤ALT<80 U/L),ALT大于等于正常上限2倍增高的慢性乙型肝炎患者122例(ALT≥80 U/L)。采用全自动血细胞分析仪检测血常规参数,采用全自动生化分析仪检测肝功能,采用荧光定量PCR分析仪检测被测者的病毒载量,用协方差分析检验在不同病变阶段中病毒载量对慢性乙型肝炎患者红细胞参数的影响。结果:在ALT正常组中,病毒载量对红细胞系统参数影响较弱,而在ALT异常组中,病毒载量对红细胞系统参数有明显影响,且以ALT≥正常上限2倍组中为甚,具体表现为随着病毒载量的增加,红细胞计数[低复制组(4.10±0.67)×1012/L,中复制组(3.92±0.69)×1012/L,高复制组(3.54±0.90)×1012/L]、血红蛋白[低复制组(129.66±21.12)g/L,中复制组(126.23±23.38)g/L,高复制组(112.98±27.77)g/L]、红细胞压积(低复制组37.66±5.68,中复制组37.03±6.03,高复制组33.34±8.15)降低(P=0.006,0.007,0.010),而红细胞平均体积[低复制组(92.17±6.53)f L,中复制组(94.85±7.95)f L,高复制组(101.63±11.33)f L]、红细胞平均血红蛋白量[低复制组(31.70±2.22)pg,中复制组(33.11±3.62)pg,高复制组(34.65±3.13)pg]、红细胞平均血红蛋白浓度[低复制组(344.28±17.17)g/L,中复制组(351.33±16.90)g/L,高复制组(358.12±15.67)g/L]、红细胞分布宽度标准差[低复制组(52.49±9.04)f L,中复制组(56.96±7.19)f L,高复制组(61.23±7.23)f L)]升高(P=0.000,0.000,0.002,0.000)。结论:通过观察病毒载量对慢性乙型肝炎患者红细胞参数的影响,可以反映在不同病变阶段乙型肝炎病毒与免疫反应的关系,以及对肝功能的影响,可以为临�Objective：To evaluate the effect of the viral load on the red blood cell parameters in chronic hepatitis B patients and its clinical significance.Methods：In the study,373 chronic hepatitis B patients were recruited,including 123 alanine transaminase （ALT） normal patients （ALT ＜ 40 U/L）,128 ALT greater than or equal to the upper limit of normal,and less than 2 times higher than the upper limit of normal patients（40 U/L ≤ ALT ＜ 80 U/L）,and 122 ALT greater than or equal to 2 times higher than the upper limit of normal patients （ALT ≥ 80 U/L）.The blood routine parameters were measured by automatic blood cell counter.The liver function parameters were measured by automatic biochemical analyzer,the hepatitis B virus loads were measured by quantitative PCR analyzer and the results were analyzed by covariance analysis.Results：In the ALT normal chronic hepatitis B patients group,the viral load had minor effects on the red blood cell parameters.But in the ALT abnormal chronic hepatitis B patients group,the viral load had a significant effect on the red blood cell parameters,and the effect was most manifest in the ALT ≥ double upper limit of normal group.The specific performance was that with the viral load increasing,the red blood cell [low copies group （4.10 ±0.67） × 1012/L,medium copies group （3.92 ±0.69） × 1012/L,high copies group （3.54 ±0.90） × 1012/L],the hemoglobin[low co-pies group （129.66 ±21.12） g/L,medium copies group （126.23 ±23.38） g/L,high copies group （112.98 ± 27.77） g/L],the hematocrit （low copies group 37.66 ± 5.68,medium copies group 37.03 ± 6.03,high copies group 33.34 ± 8.15） decreased （P =0.006,0.007,0.010）,the mean corpuscular volume [low copies group （92.17 ± 6.53） fL,medium copies group （94.85 ± 7.95） fL,high copies group （101.63 ± 11.33） fL],the mean corpuscular hemoglobin [low copies group （31.70 ± 2.22） pg,medium copies group （33.11 ± 3.62） pg,high copies group （34.65 ± 3.13） pg],the mean cor

关 键 词：肝炎 乙型 慢性 病毒载量 红细胞 

分 类 号：R512.62[医药卫生—内科学]