HBeAg阴性慢性乙肝合并肝硬化患者血清HBV-DNA水平与肝功能的相关性  

Correlation between serum HBV-DNA level and liver function in patients with HBeAg-negative chronic hepatitis B complicated with cirrhosis

作　　者：郭强 赵科孝 GUO Qiang;ZHAO Ke-xiao(Third Department of Internal Medicine,FupingCounty Hospital,Weinan 711700,Shaanxi,CHINA;Department of Infectious Diseases,Baoji Hospital Affiliated to Xi'anMedical College,Baoji 721006,Shaanxi,CHINA)

机构地区：[1]富平县医院内三科,陕西渭南711700 [2]西安医学院附属宝鸡医院传染科,陕西宝鸡721006

出　　处：《海南医学》2019年第8期973-976,共4页Hainan Medical Journal

摘　　要：目的分析HBeAg阴性慢性乙肝合并肝硬化患者的肝纤维化和肝功能指标的改变情况,探讨肝纤维化、肝功能指标与血清HBV-DNA的相关性,为临床患者诊疗提供借鉴。方法选取2016年10月至2018年10月间在富平县医院接受治疗的HBeAg阴性慢性乙肝患者106例,依据患者是否合并肝硬化分组,合并肝硬化者50例为观察组,无肝硬化者56例为对照组,采集患者空腹静脉血5 mL,免疫荧光定量分析仪检测血清HBeAg含量,实时免疫荧光PCR检测血清HBV-DNA含量,免疫速率法检测血清单胺氧化酶(MAO)含量,免疫比浊法检测血清透明质酸(HA)含量,全自动生化分析仪检测血清球蛋白(G)、谷草转氨酶(AST)、白蛋白(A)与谷丙转氨酶(ALT)含量,Pearson相关性分析肝纤维化、肝功能指标和血清HBV-DNA相关性。结果观察组患者血清MAO含量为(18.67±7.29) mmol/L、HA含量为(527.18±26.51) mg/L、AST/ALT比值为1.26±0.50,均明显高于对照组的(14.68±7.14) mmol/L、(256.30±26.19) mg/L、0.73±0.49,血清A含量为(39.68±3.20) g/L、ALT含量为(141.09±18.64) U/L、A/G比值为1.12±0.41,均明显低于对照组的(41.71±3.39) g/L、(240.18±18.53) U/L、1.35±0.43,差异均有统计学意义(P<0.05);观察组患者血清HBV-DNA含量为(6.20±1.25) lgcopies/mL,明显高于对照组的(5.59±1.21) lgcopies/mL,差异有统计学意义(P<0.05),而观察组和对照组患者的血清HBeAg含量分别为(3.34±1.12) lgCOI、(3.56±1.09) lgCOI,差异无统计学意义(P>0.05);血清HBV-DNA含量与A/G呈负相关(r=-0.359,P<0.05),与MAO、HA及AST/ALT呈正相关(r=0.512、0.440、0.401,P<0.05)。结论 HBeAg阴性慢性乙肝合并肝硬化者其体内病毒载量上升会造成肝脏储备功能降低、肝实质受损和肝纤维化,对临床患者行HBV-DNA定量分析可指导患者诊疗。Objective To analyze the changes of liver fibrosis and liver function indexes in patients with HBeAg-negative chronic hepatitis B complicated with cirrhosis,as well as the correlation between liver fibrosis,liver function indexes and serum HBV-DNA,in order to provide reference for clinical treatment.Methods A total of 106 patients with HBeAg-negative chronic hepatitis B who were treated in Fuping County Hospital from October 2016 to October 2018 were enrolled.According to the patients with or without cirrhosis,50 patients with cirrhosis were included in the observation group,and 56 patients without cirrhosis were included as the control group.Fasting venous blood (5 mL) was collected from patients.Serum HBeAg content was detected by immunofluorescence quantitative analyzer,and serum HBV-DNA content was detected by real-time immunofluorescence PCR.Serum monoamine oxidase (MAO) content was detected by immunological rate method,and immune turbidity was detected.The serum hyaluronic acid (HA) content was detected by the method,and the serum globulin (G),aspartate aminotransferase (AST),albumin (A),and alanine aminotransferase (ALT) were detected by an automatic biochemical analyzer.The correlation between liver fibrosis, liver function indicators and serum HBV-DNA was analyzed by Pearson correlation analysis.Results The serum MAO content,HA content,and AST/ALT ratio of the observation group were (18.67±7.29) mmol/L,(527.18±26.51) mg/L,and 1.26±0.50,significantly higher than (14.68±7.14) mmol/L,(256.30±26.19) mg/L,0.73±0.49 in the control group.Serum A content,ALT content,and A/G ratio were (39.68±3.20) g/L,(141.09±18.64) U/L,1.12±0.41,significantly lower than (41.71±3.39) g/L,(240.18±18.53) U/L,1.35±0.43 of the control group (P<0.05).The serum HBV-DNA content was (6.20±1.25) lgcopies/mL in the observation group,significantly higher than (5.59±1.21) lgcopies/mL in the control group (P<0.05).The serum HBeAg levels of the two groups were (3.34±1.12) lgCOI and (3.56±1.09) lgCOI,respectively, and the diffe

关 键 词：HBEAG阴性 乙型肝炎 肝硬化 HBV-DNA水平 肝纤维化 

分 类 号：R512.62[医药卫生—内科学]