合并感染肝吸虫对慢性乙型肝炎患者肝功能和病毒复制的影响  

Impact of Clonorchis sinensis coinfection on liver function and HBV DNA copies in patients with chronic hepatitis B

作　　者：董慧敏[1] 宋志兴[1] 张宏斌[1] 叶彩玲 罗敏琪[1] 

机构地区：[1]中山大学附属第三医院检验科,广东广州510630

出　　处：《现代预防医学》2017年第22期4218-4221,共4页Modern Preventive Medicine

摘　　要：目的探讨合并感染肝吸虫对慢性乙型肝炎患者肝功能和病毒复制水平的影响。方法运用速率法和氧化法分别定量检测46例正常人、45例单纯肝吸虫感染患者、652例单纯慢性乙型肝炎患者和46例慢性乙型肝炎合并感染肝吸虫患者血清中的ALT、AST和TB的含量;同时运用荧光定量聚合酶链反应(FQ-PCR)检测慢性乙型肝炎患者的病毒复制指标HBV-DNA的水平。结果与正常组相比,慢乙肝组和肝吸虫组的ALT、AST和TB的表达水平明显升高,差异有统计学意义(P<0.05);与肝吸虫组相比,慢乙肝组ALT、AST和TB水平升高的幅度更大,差异有统计学意义(P<0.05);合并感染组ALT、AST和TB的表达水平明显高于慢乙肝组,差异有统计学意义(P<0.01),同时HBV-DNA的表达水平也升高,差异有统计学意义(P<0.05)。结论乙肝病毒感染和肝吸虫感染均会损害肝功能,但乙肝病毒对肝功能的损害更为严重,合并感染肝吸虫会进一步加重慢性乙型肝炎患者的肝功能损害,同时会促进乙型肝炎病毒的复制。研究结果可用来指导临床用药及选择正确的治疗方案来防控疾病。Objective The aim of this study was to investigate the impact of Clonorchis sinensis （C. Sinensis） coinfection on liver function and HBV-DNA copies in patients with chronic hepatitis B （CHB）. Methods 46 healthy people （healthy control）, 45 patients infected with C. Sinensis （C. sinensis group）, 652 patients infected with chronic HBV （CHB group）, and 46 patients coinfected with HBV and C. Sinensis （coinfected group） were studied and compared. HBV-DNA was detected by quantitative polymerase chain reaction （FQ-PCR）. Liver functions （ALT, AST, TB） were detected by rate and oxidation method simultaneously. Results Compared with the healthy control, in CHB group and C. Sinensis group, ALT and AST increased, as well as TB in CHB group （P〈0.05）. ALT, AST and TB increased more greatly in CHB group than in C. Sinensis group （P〈0.05）. Compared with CHB group, in coinfected group, ALT, AST and TB increased remarkably （P〈0.01）, meanwhile, HBV DNA copies increased （P〈0.05）. Conclusion Both HBV and C. Sinensis infection can damage liver function, but the former was more serious. Patients with concomitant C. sinensis and HBV infection presented weaker liver function and higher HBV DNA copies.

关 键 词：慢性乙型肝炎 肝吸虫 合并感染 肝功能 HBV-DNA 

分 类 号：R512.6[医药卫生—内科学]