慢性乙型肝炎患者乙型肝炎病毒基因型与血清病毒学指标相关性分析  

Correlation between HBV genotypes and serum virological indexes in patients with chronic hepatitis B

作　　者：杨色娟 刘小六 Yang Sejuan;Liu Xiaoliu(Department of Clinical Laboratory,Xinglin Branch,First Affiliated Hospital of Xiamen University,Xiamen,Fujian361022,China;Department of Blood Transfusion,Xinglin Branch,First Affiliated Hospital of Xiamen University,Xiamen,Fujian361022,China)

机构地区：[1]厦门大学附属第一医院杏林分院检验科,福建厦门361022 [2]厦门大学附属第一医院杏林分院输血科,福建厦门361022

出　　处：《实用医技杂志》2023年第5期334-338,共5页Journal of Practical Medical Techniques

摘　　要：目的探讨慢性乙型肝炎(CHB)患者乙型肝炎病毒(HBV)基因型和血清病毒学指标特征,并分析其相关性。方法选取2019年1月至2023年1月于厦门大学附属第一医院杏林分院收治的185例CHB患者作为研究对象。分别用微流基因芯片法、实时荧光定量聚合酶链反应(PCR)和化学发光微粒子免疫分析法检测各患者HBV基因型、HBV DNA载量和乙型肝炎e抗原(HBeAg)。结果185例CHB患者中HBV B型、HBV C型和其他类型分别为92例、73例和20例;无症状携带者(ASC)、慢性轻中度乙型肝炎(CMHB)、慢性重度乙型肝炎(CSHB)和肝硬化(LC)4组HBV基因型分布比较,差异有统计学意义(P<0.05)。185例CHB患者中HBeAg阳性和HBV DNA阳性分别为54例和68例;ASC组、CMHB组、CSHB组和LC组4组血清HBeAg和HBV DNA阳性率比较,差异有统计学意义(P<0.05)。CHB患者HBV基因型不同,其HBeAg和HBV DNA阳性率比较,差异有统计学意义(P<0.05)。不同HBV基因型在性别、年龄、γ-谷氨酰转肽酶(GGT)和腺苷脱氨酶(ADA)比较上差异无统计学意义(P>0.05),但在丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)和甲胎蛋白(AFP)比较上差异有统计学意义(P<0.05)。经Logistic逐步回归分析得知,HBeAg、HBV DNA和AFP水平与HBV基因型状态相关(P<0.05)。结论该地区CHB患者HBV基因型以B和C型为主,与HBeAg和HBV DNA相关,其中HBV C型CHB患者肝损严重,更易进展为肝硬化和肝癌,须引起临床重视。Objective To investigate the characteristics of HBV genotypes and serum virological indexes in patients with chronic hepatitis B(CHB),and analyze their correlation.Methods One hundred eighty-five patients with CHB admitted to Xinglin Branch,First Affiliated Hospital of Xiamen University from January 2019 to January 2023 were selected as the research objects.HBV genotypes,HBV DNA load and HBeAg were detected by microfluidic microarray,real-time fluorescent quantitative PCR and chemiluminescent microparticle immunoassay.Results Among 185 CHB patients,there were 92 cases of HBV type B,73 cases of HBV type C and 20 cases of other types.There were significant differences in HBV genotype distribution among asymptomatic carriers(ASC),chronic mild-moderate hepatitis B(CMHB),chronic severe hepatitis B(CSHB)and liver cirrhosis(LC)groups(P<0.05).There were 54 and 68 HBeAg-positive and HBV DNA-positive patients among 185 CHB patients,respectively.The comparison of positive rates of HBeAg and HBV DNA in ASC group,CMHB group,CSHB group and LC group were significantly different(P<0.05).The HBV genotypes of CHB patients were different and the positive rates of HBeAg and HBV DNA in CHB patients with different HBV genotypes were significantly different(P<0.05).There were no significant differences in gender,age,GGT and ADA among different HBV genotypes(P>0.05),but there were significant differences in ALT,AST and AFP(P<0.05).Logistic regression analysis showed that the levels of HBeAg,HBV DNA and AFP were significantly correlated with HBV genotype status(P<0.05).Conclusion HBV genotype B and C are the predominantly genotypes of CHB patients in this area,which are significantly correlated with HBeAg and HBV DNA,and CHB patients with HBV genotype C have severe liver damage and are more likely to progress to cirrhosis and liver cancer,which should be paid attention to in clinic.

关 键 词：乙型肝炎 慢性 基因型 病毒学 相关性分析 

分 类 号：R512.62[医药卫生—内科学]