慢乙肝前C区变异与肝纤维化及血瘀证相关研究

Studies on the Relationship Among Precore Mutant, Hepatic Fibrosis and Blood Stasis Syndrome in Chronic Hepatitis B(CHB) Patients

目的:通过对慢乙肝HBV前C区1896变异、肝纤维化指标的分析,为临床辨证提供客观化指标。方法:研究组为慢乙肝患者前C区变异阳性和阴性各70例,对照组为30例健康献血员。分别检测肝纤维化指标系列,HBVDNA前C区变异等指标。结果:肝纤指标阳性组显著高于阴性组和对照组,阴性组显著高于对照组;阴性组内HA、PCⅢ、Ⅳ.C水平重度>中度>轻度;阳性组内HA、PCⅢ、Ⅳ.C、LN水平重度>中度>轻度。结论:联合检测HA、PCⅢ、Ⅳ.C、LN或许可作为血瘀证辨证指标之一。

AIM:Through the analysis of hepatic fibrosis indices and CHB patients' HBV precore mutant in 1896 site, also by means of Traditional Chinese Medicine(TCM) Syndrome differentiation and western medicine diagnosis, and hepatic fibrosis indicator analysis, the distributive characteristics of TCM syndromes in patients and the pathogenesis were investigated so as to provide objective data with clinical Syndrome differentiation of TCM.METHODS: 140 CHB patients were divided into two groups, HBV precore mutant positive group(70 cases) and HBV precore mutant negative group(70 cases), Besides, 30 healthy donors were taken as the control group. The serial indices of liver fibrosis(including HA, PCⅢ, Ⅳ.C and LN), and the HBV precore variant strains were tested. Patients in the study groups were categorized as six Syndromes according to TCM diagnostic theory. RESULTS: There existed significant distributive differences between the two study groups. The level of hepatic fibrosis indices was found higher in mutation positive group than in the negative and control group, and the level in the mutation negative group was higher than in the control group. In the mutation negative group, the severe hepatitis B patients had considerably higher level of HA, PCⅢ and Ⅳ.C than the medium patients had, and the level in the medium patients was markedly higher than in the mild patients. Similar results were seen with HA, PCⅢ, Ⅳ.C and LN level in mutation positive group concerning the severe, medium and mild patients. Conclusion:Blood Stasis Syndrome exists in different stages as one of the basic syndrome of CHB patients with precore mutation. The level of HA, PCⅢ, Ⅳ.C and LN level may be taken as one of the objective data in confirming Blood Stasis Syndrome.