血清HBsAg、HBV DNA水平及相关性在慢性HBV感染过程的变化和意义  

Changes and Significance of Serum HBsAg,HBV DNA Levels and Their Correlation in Chronic HBV Infection

作　　者：胡金燕 林坤培 周兰 HU Jinyan;LIN Kunpei;ZHOU Lan(Luoding People’s Hospital,Luoding 527200,Chin)

机构地区：[1]广东省罗定市人民医院,广东罗定527200

出　　处：《中国医学创新》2018年第15期8-11,共4页Medical Innovation of China

基　　金：云浮市医学科学技术研究基金(2015B42)

摘　　要：目的:探讨血清HBsAg、HBV DNA水平及相关性在慢性HBV感染过程的变化和意义,为慢性HBV感染患者的治疗和预后评估提供必要的理论依据。方法:将2014年1月-2017年8月本院收治的80例慢性乙型肝炎病毒感染患者作为研究对象,结合患者HBV感染的不同阶段将其分为IT组(免疫耐受)、IC组(免疫清除)、LR组(低复制期)、ENH组(再活动期),每组20例。比较慢性HBV感染过程中不同阶段血清HBsAg、HBV DNA水平,分析血清HBsAg与HBV DNA相关性。结果:四组慢性HBV感染患者血清HBsAg、HBV DNA水平比较,差异均有统计学意义(P<0.05)。进一步分析IT组患者血清HBsAg、HBV DNA水平最高,LR组患者血清HBsAg、HBV DNA水平最低,差异均有统计学意义(P<0.05)。IT、IC两组患者HBV DNA水平比较,差异无统计学意义(P>0.05)。IT、LR、ENH组患者血清HBsAg与HBV DNA无相关性,差异均无统计学意义(P>0.05)。IC组患者血清HBsAg与HBV DNA呈正相关性,差异均有统计学意义(P<0.05)。结论:慢性HBV感染患者在不同阶段的血清HBV持续感染不同阶段HBsAg滴度具有显著性差异,IT期最高,其次为IC和ENH期,LR期最低,血清HBsAg水平仅在IC期与HBV DNA呈现正相关,慢性HBV感染患者的血清HBsAg在自然病程中不同阶段水平变化有助于预测疾病进程和评估抗病毒治疗的效果.Objective：To explore the changes and significance of serum HBsAg and HBV DNA levels and their correlation in the process of chronic HBV infection,and to provide the necessary theoretical basis for the treatment and prognosis evaluation of patients with chronic HBV infection.Method：A total of 80 cases of chronic HBV infection treated in our hospital from January 2014 to August 2017 were divided into IT（immune tolerance） group,IC（immune clearance） group,LR（low replication period） group,and ENH（reactivation period） group according to different stages.The levels of serum HBsAg and HBV DNA in different stages of chronic HBV infection were compared,the correlation between serum HBsAg and HBV DNA was analyzed.Result：The serum levels of HBsAg and HBV DNA in four groups of patients with chronic HBV infection were significantly different（P〈0.05）.Further analysis showed that the serum levels of HBsAg and HBV DNA in IT group were the highest,while the serum HBsAg and HBV DNA levels in LR group were the lowest（P〈0.05）.There was no significant difference in HBV DNA level between IT group and IC group（P〈0.05）.No correlation was found between serum HBsAg and HBV DNA in IT,LR and ENH groups（P〈0.05）.There was a positive correlation between serum HBsAg and HBV DNA in patients of IC group,the difference was statistically significant（P〈0.05）.Conclusion：HBsAg titers in patients with chronic HBV infection at different stages of persistent HBV infection are significantly different at different stages of infection,with the highest IT period followed by IC and ENH stages,the lowest LR stage,serum HBsAg level only at IC stage and HBV DNA presentation Positive correlations between serum HBsAg levels in patients with chronic HBV infection at different stages of their natural history are helpful in predicting disease progression and assessing the effectiveness of antiviral therapy.

关 键 词：乙型肝炎病毒 乙肝表面抗原 乙型肝炎病毒DNA 相关性 

分 类 号：R512.62[医药卫生—内科学]