HBV相关慢加急性肝衰竭患者HBsAg水平及病毒载量与近期预后研究  

The study of the relationship between HBsAg level,viral loads and short-term prognosis in patients with HBV-related acute-onchronic liver failure

作　　者：曹欣[1,2] 陈铿[2] 关玉娟[2] 彭劼[1] 

机构地区：[1]南方医科大学南方医院 [2]广州市第八人民医院

出　　处：《肝脏》2014年第11期819-822,共4页Chinese Hepatology

摘　　要：目的探讨HBV相关慢加急性肝衰竭(ACLF)患者HBsAg水平、HBV DNA定量与近期预后的关系。方法选取2009年1月至2013年1月在广州市第八人民医院收治的177例HBV相关ACLF患者,比较生存组与恶化组的HBsAg水平、HBV DNA定量的差异及与MELD和Child-Pugh评分的相关性。结果生存组血清HBsAg水平为(3.67±0.41)lg COI,高于恶化组的(3.54±0.36)lg COI(P<0.05),血清HBsAg定量与近期生存呈正相关(r=0.259,P=0.002),与MELD、Child-Pugh评分呈负相关(r=-0.450、-0.397,均P<0.01);据HBsAg定量得出曲线下面积(AUC)为0.657,cut-off值为6261COI。HBV DNA载量生存组为(5.64±1.65)lg IU/mL,恶化组为(5.88±1.73)lg IU/mL,两组比较差异无统计学意义(P>0.05),且与近期生存、MELD、Child-Pugh评分均无相关性(P>0.05)。结论血清HBV DNA载量与HBV相关ACLF患者的临床预后无相关性,而血清HBsAg水平与其临床预后呈正相关,HBsAg可作为临床预后判断的指标。Objective To analyze the relationship between HBsAg levels,HBV DNA loads and short-term prognosis in patients with HBV-related acute-on-chronic liver failure. Methods One hundred and seventy-seven patients with HBV-related acute-on-chronic liver failure,which was admitted in Guangzhou Eighth People’s Hospital during January 2009 to January 2013,were enrolled. Data were analyzed retrospectively by comparison between survival and deterioration group to explore relationship between HBsAg levels,HBV DNA loads and short-term prognosis,model for end-stage liver disease （MELD）,Child-Pugh score. Results Serum HBsAg levels in survival group were significantly higher than those in deterioration group（P〈0.05）. Serum HBsAg quantification was positively correlated with short-term survival （r= 0.259, P= 0.002）,but negatively correlated with MELD and Child-Pugh score （r= -0.450 and -0.397 respectively,both P values〈0.001）. It was conducted that area under the curve （AUC）was 0.657 and cut-off level was 6261COI for serum HBsAg quantification. There was no significant difference in HBV DNA loads between survival and deterioration groups （P〉0.05）,and no obvious relationships between HBV DNA loads and short-term prognosis,MELD,Child-Pugh score were found （all P values〉0.05）. Conclusion The HBV DNA loads had no correlation with short-term prognosis in patients with HBV-related ACLF,while serum HBsAg level was positively correlated with？clinical prognosis;thus,serum HBsAg quantification could be used as a new prognostic predictor.

关 键 词：乙型 肝炎 慢加急性肝衰竭 乙型肝炎表面抗原 HBVDNA载量 MELD Child—Pugh 

分 类 号：R575.3[医药卫生—消化系统]