血清HBV-DNA及免疫球蛋白检测对慢性乙型肝炎诊断的临床价值  

Clinical value of serum HBV-DNA and immunoglobulin detection in diagnosis of chronic hepatitis B

作　　者：李锦超 Li Jinchao(Department of Clinical Laboratory,Jinan Integrated Traditional Chinese and Western Medicine Hospital,Jinan 271100,Shandong,China)

机构地区：[1]济南市中西医结合医院检验科,山东济南271100

出　　处：《实用检验医师杂志》2022年第4期357-360,共4页Chinese Journal of Clinical Pathologist

摘　　要：目的探讨检测血清乙型肝炎病毒(HBV)-DNA与免疫球蛋白(Ig)在慢性乙肝诊断及病情评估中的应用。方法选择2021年1月—2022年1月济南市中西医结合医院收治的200例慢性乙肝患者作为乙肝组,另外选择200名健康体检者作为对照组。在400名受检者中开展聚合酶链反应(PCR)检测,测定血清HBV-DNA,并开展免疫散射比浊法检测用于Ig测定,比较两组上述指标水平。根据患者实验室检查指标划分病情严重程度,分为轻度组(73例)、中度组(89例)、重度组(38例),比较不同病情严重程度慢性乙肝患者的血清HBV-DNA和Ig水平。应用Spearman相关性分析法,对血清Ig与慢性乙肝患者病情严重程度、HBV-DNA水平之间的相关性进行分析。对乙肝患者应用恩替卡韦治疗,统计治疗后的HBV-DNA转阴率,比较HBV-DNA转阴与未转阴患者治疗前后的Ig水平。结果乙肝组患者的血清HBV-DNA、IgA、IgG、IgM水平均明显高于对照组[HBV-DNA(×103拷贝/mL):6.18±2.04比3.27±0.95,IgA(g/L):4.03±1.21比2.65±0.83,IgG(g/L):14.56±3.08比11.37±2.54,IgM(g/L):2.94±0.90比1.93±0.64,均P<0.05]。乙肝轻度组、中度组、重度组的血清HBV-DNA、IgA、IgG、IgM水平比较差异均有统计学意义,且逐渐升高。患者血清IgA、IgG、IgM水平与病情严重程度和HBV-DNA均呈正相关。治疗后,HBV-DNA转阴组的血清IgA、IgG、IgM水平均明显低于未转阴组[IgA(g/L):2.49±0.65比3.21±0.73,IgG(g/L):11.42±1.17比12.86±1.34,IgM(g/L):1.83±0.42比2.31±0.49,均P<0.05]。结论慢性乙肝患者血清HBV-DNA和Ig水平均较健康人群升高,且随病情加重升高越明显,Ig水平与病情严重程度和血清HBV-DNA关系密切,临床诊治慢性乙肝时可将Ig作为病情判断及疗效评估时的辅助手段。Objective To explore the value of detecting serum hepatitis B virus(HBV)-DNA and immunoglobulin(Ig)in the diagnosis and disease assessment of chronic hepatitis B(CHB).Methods The 200 patients with CHB admitted to Jinan Integrated Traditional Chinese and Western Medicine Hospital from January 2021 to January 2022 were selected as CHB group,and other 200 health examinees were selected as control group.Polymerase chain reaction(PCR)detection was carried out in 400 subjects to determine serum HBV-DNA,and immune scattering turbidimetry was carried out to determine Ig.The levels of above indicators were compared between the two groups.According to the laboratory examination indicators of CHB,the patients were divided into mild group(73 cases),moderate group(89 cases)and severe group(38 cases),the serum HBV-DNA and Ig levels of CHB patients with different severities were compared,and Spearman correlation analysis method was used to analyze the correlation between serum Ig and the severity and the level of HBV-DNA in CHB patients.The patients in CHB group were treated with Entecavir,the HBV-DNA negative conversion rate after treatment was counted,and the Ig levels of HBV-DNA negative conversion and non-negative conversion patients before and after treatment were compared.Results The levels of serum HBV-DNA,IgA,IgG and IgM in CHB group were higher than those in control group[HBV-DNA(×10~3 copies/mL):6.18±2.04vs.3.27±0.95,IgA(g/L):4.03±1.21 vs.2.65±0.83,IgG(g/L):14.56±3.08 vs.11.37±2.54,IgM(g/L):1.83±0.42 vs.2.31±0.49,all P<0.05].In CHB patients,the levels of serum HBV-DNA,IgA,IgG and IgM in mild group,moderate group and severe group were significantly different,and increased as the desease severity increased.The levels of serum IgA,IgG and IgM in CHB patients were positively related to the disease severity and HBV-DNA.After treatment,the levels of serum IgA,IgG and IgM in HBV-DNA negative group were lower than those in HBV-DNA non-negative group[IgA(g/L):2.49±0.65 vs.3.21±0.73,IgG(g/L):11.42±1.17 vs.12.86±1.3

关 键 词：慢性乙型肝炎 免疫球蛋白 慢性乙型肝炎病毒-DNA 病情评估 

分 类 号：R512.62[医药卫生—内科学] R446.6[医药卫生—临床医学]