乙肝相关性肝硬化患者肝功能Child-Pugh分级及相关生化指标与血清中HBV DNA水平的相关性  

Study on the correlation between Child-Pugh classification of liver function and related biochemical indexes and HBV DNA level in serum of patients with hepatitis B-related cirrhosis

作　　者：李芳芳[1] 李娟[2] 余真君 LI Fangfang;LI Juan;YU Zhenjun(Special Ward,Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University,Taizhou 317000,China;Department of Pediatrics,Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University,Taizhou 317000,China;Department of Infection,Enze Hospital,Taizhou Enze Medical Center(Group),Taizhou 317000,China)

机构地区：[1]浙江省台州医院特需病区,浙江台州317000 [2]浙江省台州医院儿内科,浙江台州317000 [3]台州恩泽医疗中心(集团)恩泽医院感染科,浙江台州317000

出　　处：《中国现代医生》2022年第3期108-111,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目面上项目计划(2018KY914)。

摘　　要：目的探讨乙肝相关性肝硬化患者肝功能Child-Pugh分级及相关生化指标与患者血清中的HBV DNA水平相关性。方法选择2018年1—12月在浙江省台州医院住院的乙肝肝硬化患者200例,并根据Child-Pugh分级标准将患者分级,检测不同Child-Pugh分级患者血清中的HBV DNA水平及肝功能相关生化指标[总胆红素、凝血酶原时间、清蛋白、谷草转氨酶/谷丙转氨酶(AST/ALT)比值],统计分析相关性。结果三组乙肝肝硬化患者总胆红素、凝血酶原时间的水平随着肝硬化Child-Pugh分级的升高逐渐升高(P<0.001),三组患者血清AST/ALT比值呈梯度升高(P<0.001),清蛋白在三组患者中随着肝硬化Child-Pugh分级的升高逐渐降低(P<0.001),三组患者血清中HBV DNA定量与肝硬化严重程度不一致,差异无统计学意义(χ^(2)=0.560,P>0.05),HBV DNA定量与总胆红素呈正相关(r=0.267,P=0.044),但HBV DNA定量与清蛋白、凝血酶原时间、AST/ALT比值均无明显相关性(P>0.05)。结论乙肝肝硬化患者HBV DNA水平与肝硬化Child-Pugh分级及肝功能相关生化指标无明显相关性,临床上不能根据肝硬化患者病情严重程度决定是否进行抗病毒治疗。Objective To explore the correlation between Child-Pugh classification of liver function and related biochemical indexes and HBV DNA level in patients'serum in patients with hepatitis B-related cirrhosis.Methods A total of 200 patients with hepatitis B cirrhosis hospitalized in our hospital from January to December 2018 were selected and classified according to the Child-Pugh classification.The HBV DNA level and liver function related biochemical indicators(total bilirubin,prothrombin time,albumin,aspartate aminotransferase/alanine aminotransferase[AST/ALT]ratio)in serum of patients with different Child-Pugh classification were detected,and the correlation was statistically analyzed.Results The levels of total bilirubin and prothrombin time in patients with hepatitis B cirrhosis in three groups gradually increased with the increase of Child-Pugh grade of liver cirrhosis(P<0.001).The ratio of AST/ALT in serum of three groups increased gradually(P<0.001),while albumin in three groups gradually decreased with the increase of Child-Pugh grade of liver cirrhosis(P<0.001).There was no significant difference between serum HBV DNA quantification and the severity of liver cirrhosis in the three groups(χ^(2)=0.560,P>0.05).There was a positive correlation between HBV DNA quantification and total bilirubin(r=0.267,P=0.044),but there was no significant correlation between HBV DNA quantification and albumin,prothrombin time and AST/ALT ratio(P>0.05).Conclusion There is no obvious correlation between HBV DNA level and Child-Pugh classification of liver cirrhosis and biochemical indexes related to liver function in patients with hepatitis B cirrhosis.It is impossible to decide whether to take antiviral treatment according to the severity of liver cirrhosis.

关 键 词：乙肝相关性肝硬化 乙型肝炎病毒脱氧核糖核酸 肝功能CHILD-PUGH分级 肝功能相关生化指标 

分 类 号：R575.2[医药卫生—消化系统]