HBV共价闭合环状DNA与血清HBV DNA、HBsAg、ALT、年龄的相关性研究  

Intrahepatic hepatitis B virus covalently closed circular DNA correlation with serum HBV DNA, serum HBsAg, alanine aminotransferase and age

作　　者：谢琴秀[1] 江晓平[1] 张亚飞[1] 胡向阳[2] 李旭[1] 李家斌[1] 朱圣涛 蔡文婕[1] 

机构地区：[1] 安徽医科大学第一附属医院感染病科,合肥230032 [2] 安徽医科大学第一附属医院病理科,合肥230032

出　　处：《中华肝脏病杂志》2015年第6期418-421,共4页Chinese Journal of Hepatology

基　　金：国家自然科学基金（81072342）

摘　　要：目的 了解HBV共价闭合环状DNA （cccDNA）与血清HBV DNA、HBsAg、ALT、患者年龄等临床指标的关系,探讨这些指标替代HBV cccDNA的价值. 方法 60例慢性HBV感染者在B型超声的引导下,采用1s快速切割组织法获取肝组织,用荧光定量PCR法检测肝组织HBVcccDNA和血清HBV DNA,用全自动化学发光仪（雅培I-2000）检测血清HBsAg,并检测其他临床指标如ALT、AST、Y谷氨酰转移酶、碱性磷酸酶、白蛋白、球蛋白、白细胞、血小板、凝血酶原国际标准化比值和人口学资料,并分析这些指标与肝组织HBV cccDNA的相关性.相关性分析用Spearman或Pearson方法. 结果 肝组织中的HBV cccDNA与患者年龄、球蛋白、ALT和肝组织炎症分级显著负相关,≤30岁组HBV cccDNA水平显著高于＞30岁组,分别为（7.44＆#177;0.58） log10拷贝/ml和（5.66＆#177;1.35）log10拷贝/ml,两组间差异有统计学意义（t=7.157,P＜0.001）,而与血清HBV DNA和血清HBsAg呈显著正相关（r值分别为0.916、0.727,P值均＜0.001）,HBV cccDNA与血清HBVDNA、HBsAg比值的中位值分别为1.18和1.67.结论 肝组织HBV cccDNA随着年龄增长而下降,高球蛋白、高ALT和肝组织炎症重者其肝组织HBV cccDNA越低,随着血清HBV DNA和HBsAg水平升高而升高;血清HBV DNA和HBsAg水平可在一定程度上反应肝组织的HBV cccDNA水平.Objective To investigate the correlation between intrahepatic eovalently closed circular （ccc）DNA of hepatitis B virus （HBV） and pathogen-and patient-related parameters.Methods Ultrasound-guided liver biopsies were obtained from 60 patients with chronic HBV infection.Levels of intrahepatic HBV cccDNA and serum HBV DNA were measured by quantitative fluorescence PCR.Level of serum hepatitis B surface antigen （HBsAg） was measured by chemiluminescence immunoassay.Clinical parameters,such as alanine aminotransferase （ALT）,aspartate aminotransferase （AST）,gamma-glutamyl transferase （GGT）,alkaline phosphatase （AKP）,albumin,globulin （GLO）,white blood cell,platelet,prothrombin-international normalized ratio,were measured by standard assay.Demographic information was recorded.The correlation between intrahepatic HBV cccDNA and pathogen-and patient-related parameters was assessed.Results Intrahepatic HBV cccDNA level was negatively correlated with age,GLO,ALT and grade of necroinflammation.Patients with age of 30 years or more showed significantly higher level of HBV cccDNA level than patients under 30 years-old （7.44＆#177;0.58 and 5.66＆#177;1.35; t =7.157,P 〈 0.001）.Intrahepatic HBV cccDNA level was positively correlated with serum HBV DNA level （r =0.916,P 〈 0.001） and serum HBsAg level （r =0.727,P 〈 0.001）.The median ratio of HBV cccDNA to HBV DNA was 1.18,and of HBV cccDNA to HBsAg was 1.67.Conclusion Intrahepatic HBV cccDNA levels decrease with age,level of ALT,level of GLO and grade of liver necroinflammation,but increase with level of serum HBV DNA and level of serum HBsAg.To a certain extent,serum HBV DNA and serum HBsAg levels may be a sufficient marker of intrahepatic HBV cccDNA levels.

关 键 词：肝炎表面抗原 乙型 年龄因素 血清学 

分 类 号：R512.62[医药卫生—内科学]