慢性乙型肝炎患者血清HBVDNA载量与肝功能指标关系研究

目的研究慢性乙型肝炎患者不同临床分型与HBVDNA载量及肝功能之间的关系。方法分别采用实时荧光定量PCR法及速率法对482例慢性乙型肝炎(CHB)进行血清HBVDNA定量和ALT、AST检测,根据其临床分型分为e--CHB、e+-CHB,分别观察其与HBVDNA载量、ALT、AST水平关系。结果 e--CHB与e+-CHB相比,前者年龄远大于后者(P<0.01),血清HBVDNA载量低于后者(P<0.01),血清ALT、AST水平高于后者(P<0.01)。e--CHB组随血清HBVDNA载量升高,其ALT、AST水平进行性升高(P<0.05),e+-CHB组血清ALT、AST水平与HBVDNA载量无关。结论 CHB不同临床分型在病毒学、生化学存在明显不同,对于e+-CHB患者HBeAg阳性是判断HBV复制的良好指标,其体内HBVDNA载量与肝脏炎症程度无关。e--CHB患者体内HBVDNA载量与肝内炎症程度相关,应重视对e--CHB患者的随访和治疗。

Association Study of Serum HBV DNA Level and Indicators of Liver Function in Patients with Chronic Hepatitis B

Objective To explore the associations between different clinical stages(HBeAg negative and HBeAg positive CHB) and serum HBV DNA level or indicators of liver function(ALT/AST) in patients with chronic hepatitis B(CHB).Methods HBV DNA level and serum ALT/AST were detected by quantitative Real-time PCR and velocity methods separately and the associations between HBV DNA level and serum ALT/AST both in HBeAg negative CHB and HBeAg positive CHB patients were analyzed accordingly.Results The average age of eAg-CHB patients were elder than that of eAg+CHB patients(P<0.01).Serum HBV DNA level was higher in eAg-CHB patients than in eAg+CHB patients(P<0.01) and ALT/AST displayed the opposite trend(P<0.01).Serum HBV DNA level was positively correlated with serum ALT/AST in eAg-CHB patients(P<0.05) and no similar correlation was found in eAg+ CHB patients.Conclusion The different clinical CHB stages shows different virological and biochemical characteristics.Positive serum HBeAg is an effective indicator of HBV high intrahepatic replication and no correlation were presented between HBV DNA level and intrahepatic inflammation in eAg+ CHB patients.However,HBV DNA level is closely correlated with liver function parameters(ALT/AST) in eAg-CHB patients.It is emphasized that more attention should be paid to clinical treatment and follow-up monitoring of e——CHB patients.