慢加急性肝衰竭、慢性肝衰竭患者血清HBV标志物水平变化及其与MELD评分的关系  

Changes in levels of hepatitis B virus markers in patients with acute-on-chronic liver failure and chronic liver failure and their relationships with MELD scores

作　　者：鲁旭[1,2] 韩涛[2] 李莹[2] 张倩[1,2] 

机构地区：[1]天津医科大学第三中心临床学院,天津300170 [2]天津市第三中心医院天津市肝胆疾病研究所天津市人工细胞重点实验室

出　　处：《山东医药》2015年第27期1-3,共3页Shandong Medical Journal

基　　金：艾滋病和病毒性肝炎等重大传染病防治国家科技重大专项基金资助(2012ZX10002004-011);天津市科技计划项目(13RCGFSY19200)

摘　　要：目的观察慢加急性肝衰竭(ACLF)、慢性肝衰竭(CLF)患者血清HBV标志物水平变化,并分析其与终末期肝病模型(MELD)评分的相关性。方法 ACLF患者62例(ACLF组)、CLF患者52例(CLF组)、慢性乙型肝炎(CHB)患者50例(CHB组)。采用电化学发光法检测血清HBs Ag、HBe Ag、HBc Ab,并计算MELD评分。分析ACLF组、CLF组血清HBs Ag、HBe Ag、HBc Ab水平与MELD评分的相关性。结果 ACLF组、CLF组血清HBs Ag水平降低,与CHB组相比,P均<0.05。ACLF组、CLF组HBe Ag阳性者血清HBs Ag水平低于CHB组(P均<0.01)。CLF组HBe Ag阴性患者血清HBs Ag水平低于CHB组(P<0.05)。CHB组内,HBe Ag阳性、HBe Ag阴性患者血清HBs Ag、HBc Ab水平相比,P均<0.05。ACLF组、CLF组MELD评分分别为(23.65±5.23)、(19.73±5.01)分,两组相比,P<0.01。ACLF组、CLF组血清HBs Ag、HBe Ag、HBc Ab水平与MELD评分无相关性(P均>0.05)。结论 ACLF、CLF患者血清HBs Ag水平较CHB患者降低;ACLF、CLF患者的病情严重程度、预后情况与HBV标志物水平无相关性。Objective To observe the changes in levels of hepatitis B virus markers in patients with acute-on-chronic liver failure （ ACLF） and chronic liver failure （ CLF） and to investigate their relationships with model for end-stage liver disease （MELD） scores.Methods The levels of HBsAg, HBeAg and HBcAb were detected by Abbott chemiluminescence in 62 ACLF patients （ACLF group）, 52 CLF patients （CLF group） and 50 patients with chronic hepatitis B （CHB） （CHB group） and MELD scores were calculated.In the ACLF and CLF groups, the correlations of HBsAg, HBeAg and HBcAb with MELD scores were analyzed.Results Compared with the CHB group, HBsAg level decreased in the ACLF and CLF groups, which showed a statistically significant difference （all P〈0.05）.Serum HBsAg levels of HBeAg-positive patients in the ACLF and CLF groups were lower than that in the CHB group （all P〈0.01）.Serum HBsAg level of HBeAg-negative patients in the CLF group was lower than that in the CHB group （P〈0.05）.There were significant differences in the HBsAg and HBcAb levels between HBeAg positive and negative patients in the CHB group （all P〈0.05）.The MELD scores were （23.65 ±5.23） and （19.73 ± 5.01） in the ACLF group and CLF group, which showed a significant difference （P〈0.01）.HBsAg, HBeAg and HBcAb levels had no correlation with MELD scores in the ACLF and CLF groups （all P〈0.05）.Conclusion Serum HBsAg levels in the ACLF and CLF patients were significantly lower than that in the CHB patients.HBV markers showed no correlation with the con-dition and prognosis of patients with ACLF and CLF.

关 键 词：慢性乙型肝炎 肝功能衰竭 慢加急性肝衰竭 慢性肝衰竭 乙型肝炎病毒 乙型肝炎病毒标志物 终末期肝病模型 

分 类 号：R575.3[医药卫生—消化系统]