HBeAg(+)与(-)HBV感染者HBV-DNA载量及其与肝纤维化和MELD评分的关系  

HBV-DNA load of HBeAg(+)and(-)patients with HBV infection and its association with liver fibrosis and MELD score

作　　者：吴清艳 陈柳虹 王日 韩朝辉 WU Qing-yan;CHEN Liu-hong;WANG Ri;HAN Chao-hui(Haikou Third People′s Hospital,Haikou,Hainan 571100,China)

机构地区：[1]海口市第三人民医院检验科,海南海口571100

出　　处：《中华医院感染学杂志》2023年第14期2096-2099,共4页Chinese Journal of Nosocomiology

基　　金：海南省自然科学基金资助项目(819MS142)。

摘　　要：目的分析乙肝е抗原(HBeAg)(+)与(-)乙型肝炎病毒(HBV)感染者HBV-DNA载量及其与肝纤维化和终末期肝病模型(MELD)评分的关系。方法选取2018年6月-2021年6月在海口市第三人民医院确诊的94例HBV感染患者为研究对象,分为HBeAg(+)组60例和HBeAg(-)组34例。采用荧光定量聚合酶链反应法检测两组患者血清HBV-DNA载量,并检测两组患者的肝纤维化指标[透明质酸(HA)、Ⅲ型前胶原PC(Ⅲ)、Ⅳ型胶原(CⅣ)、层黏蛋白(LN)]和MELD评分,分析HBV-DNA载量与肝纤维化和MELD评分的关系。结果HBeAg(+)组患者的白蛋白(ALB)、天冬氨酸转氨酶(AST)、总胆红素(TBIL)、谷丙转氨酶(ALT)水平及MELD评分高于HBeAg(-)组(P<0.05),PCⅢ、CⅣ、LN、HA水平高于HBeAg(-)组(P<0.05),Pearson相关性分析结果显示,HBeAg(+)患者HBV-DNA载量与肝纤维化指标和MELD评分均呈正相关(P<0.05)。结论不同HBV感染阶段患者HBV-DNA载量与肝纤维化及MELD评分密切相关,HBeAg(+)患者的肝纤维化进展较严重,且MELD评分较高。OBJECTIVE To analyze the hepatitis B virus(HBV)-DNA load of hepatitis B e antigen(HBeAg)(+)and(-)infection patients and observe its association with liver fibrosis and model for end-stage liver disease(MELD)score.METHODS Totally 94patients who were diagnosed with HBV infection and treated in Haikou Third People′s Hospital from Jun 2018to Jun 2021were recruited as the study subjects and were divided into the HBeAg(+)group with 60cases and the HBeAg(-)group with 34cases.The serum HBV-DNA load was detected for the two groups of patients by using fluorescent quantitative polymerase chain reaction.The liver fibrosis indexes[hyaluronic acid(HA),type III procollagen(PC III),type IV collagen(CIV),laminin(LN)]and MELD score were detected,and the association of HBV-DNA load with liver fibrosis and MELD score was observed.RESULTS The levels of albumin(ALB),aspartate aminotransferase(AST),total bilirubin(TBIL)and alanine aminotransferase(ALT)as well as MELD score were higher in the HBeAg(+)group than in the HBeAg(-)group(P<0.05);the levels of PCⅢ,CⅣ,LN and HA of the HBeAg(+)group were higher than those of the HBeAg(-)group(P<0.05).The result of Pearson correlation analysis showed that the HBV-DNA load of the HBeAg(+)patients was positively correlated with the liver fibrosis indexes and MELD score(P<0.05).CONCLUSION The HBV-DNA load of the HBV infection patients is closely associated with the liver fibrosis and MELD score,the HBeAg(+)patients have more severe progression of liver fibrosis and higher MELD score.

关 键 词：乙肝е抗原 乙型肝炎病毒 DNA载量 血清标志物 肝纤维化 终末期肝病模型 

分 类 号：R512.62[医药卫生—内科学]