慢性乙型肝炎患者HBV-DNA载量与肝功能、肝纤维化程度及T淋巴细胞亚群的关系  

Relationship between HBV-DNA load and liver function,liver fibrosis an T lymphocyte subsets in patients with chronic hepatitis B

作　　者：李娟 董先芳 李玲 徐敏玲 隋松兰 LI Juan;DONG Xianfang;LI Ling;XU Minling;SUI Songlan(Shandong Public Health Clinical Center,Jinan,Shandong 250100,China)

机构地区：[1]山东省公共卫生临床中心重症肝病科,山东济南250100 [2]山东省公共卫生临床中心肝硬化一病区,山东济南250100 [3]山东省公共卫生临床中心感染一科,山东济南250100 [4]山东省公共卫生临床中心门脉高压介入/血管外科,山东济南250100

出　　处：《中华医院感染学杂志》2025年第4期490-494,共5页Chinese Journal of Nosocomiology

基　　金：山东省医药卫生科技基金资助项目(202314011603)。

摘　　要：目的分析慢性乙型肝炎(CHB)患者乙肝病毒(HBV)-DNA载量与其肝功能、肝纤维化程度和T淋巴细胞亚群水平,并分析各指标的相关性。方法选取2023年4月-2024年4月于山东公共卫生临床中心收治的122例C HB患者为研究对象,根据HBV-DNA载量分为高载量组(n=48,HBV-DNA载量≥10^(5)copies/ml)和低载量组(n=74,HBV-DNA载量<10^(5)copies/ml)。检测血清HBV-DNA载量、血清谷草转氨酶(AST)、谷丙转氨酶(ALT)、总胆红素(TBIL)、透明质酸(HA)、层黏连蛋白(LN)、Ⅲ型前胶原(PCⅢ)和Ⅳ型胶原(CⅣ)水平。结果高载量组CHB患者ALT、AST和TBIL分别为(113.84±11.63)、(95.65±9.78)和(60.24±7.37)U/L均高于低载量组(P<0.05)。高载量组CHB患者HA、LN、PCⅢ和CⅣ分别为(436.21±41.52)、(244.85±31.48)、(314.39±28.71)和(85.31±20.92)ng/ml均高于低载量组(P<0.05)。高载量组CD_(3)^(+)、CD_(4)^(+)和CD_(4)^(+)/CD_(8)^(+)低于低载量组(P<0.05),CD_(8)^(+)高于低载量组(P=0.001)。CHB患者ALT、AST、TBIL、HA、LN、PCⅢ、CⅣ和CD_(8)^(+)水平均与HBV-DNA载量呈正相关(r=0.522、0.513、0.494、0.421、0.456、0.503、0.418、0.311,P均<0.05),CD_(3)^(+)、CD_(4)^(+)和CD_(4)^(+)/CD_(8)^(+)水平与HBV-DNA载量呈负相关(r=-0.346、-0.454、-0.492,P均<0.001)。结论CHB患者HBV-DNA载量越高,可能与患者肝功能越差、肝纤维化程度重和免疫功能低有关。OBJECTIVE To analyze hepatitis B virus-deoxyribonucleic acid(HBV-DNA)load,liver function,liver fibrosis and T lymphocyte subsets in patients with chronic hepatitis B(CHB),and to analyze the correlation between each index.METHODS Totally 122 patients with CHB admitted to Shandong Public Health Clinical Center between Apr.2023 and Apr.2024 were selected as the research subjects,and were divided into a high-load group(n=48,≥10^(5) copies/ml)and a low-load group(n=74,<10^(5) copies/ml)according to their HBV-DNA load.Serum HBV-DNA load,aspertate aminotransferase(AST),alanine aminotransferase(ALT),total bilirubin(TBIL),hyaluronic acid(HA),laminin(LN),precollagen type Ⅲ(PCⅢ)and type Ⅳ collagen(CIV)were detected.RESULTS The ALT,AST,and TBIL levels of CHB patients in the high load group were(113.84±11.63),(95.65±9.78),and(60.24±7.37)U/L,respectively,all higher than those in the low load group(P<0.05).The HA,LN,PC Ⅲ,and C Ⅳ levels of CHB patients in the high load group were(436.21±41.52),(244.85±31.48),(314.39±28.71),and(85.31±20.92)ng/ml,respectively,which were higher than those in the low load group(P<0.05).CD_(3)^(+),CD_(4)^(+),and CD_(4)^(+)/CD_(8)^(+)were lower in the high load group had than in the low load group(P<0.05),while CD_(8)^(+)was higher than in the low load group(P=0.001).The levels of ALT,AST,TBIL,HA,LN,PC Ⅲ,C Ⅳ,and CD_(8)^(+)in CHB patients were positively correlated with HBV-DNA load(r=0.522,0.513,0.494,0.421,0.456,0.503,0.418,0.311,P<0.05),while thelevelsof CD_(3)^(+),CD_(4)^(+),and CD_(4)^(+)/CD_(8)^(+)were negatively correlated with HBV-DNA load(r=-0.346,-0.454,-0.492,all P<0.001).CONCLUSION Higher HBV-DNA loads in CHB patients may be associated with declined liver function,severe liver fibrosis and declined immune function in CHB patients.

关 键 词：慢性乙型肝炎 乙肝病毒载量 肝功能 肝纤维化 T淋巴细胞亚群 

分 类 号：R512.62[医药卫生—内科学]