丙型肝炎病毒RNA含量与抗-HCV及ALT的关系探讨

The relationship of between HCV RNA and Anti-HCV or ALT

目的了解丙型肝炎病毒核糖核酸(HCV RNA)与抗丙肝病毒抗体(抗-HCV)及丙氨酸氨基转移酶(ALT)的关系。方法83份确诊为丙肝的住院患者样本作观察组,95份健康体检人群样本作对照组,用荧光定量逆转录聚合酶反应(FQ-RT-PCR)检测这两组样本的HCV RNA含量,并同时采用ELISA法检测抗-HCV,用全自动生化检测仪测定ALT水平。结果观察组HCV RNA含量高于80 copy／ml者67份,抗-HCV阳性者64份,经进一步相关性分析,两者有很好的相关性(r=0．587,P=0．002);83份病例中有58份ALT异常,其异常率随HCV RNA含量的升高而增加。经统计学分析,ALT异常例数和正常例数差异有显著性(P<0．01);ALT水平和HCV RNA含量无相关性(r=0．175,P=0．095);而ALT异常率与HCV RNA含量呈正相关(r=0．903,P=0．036)。结论HCV RNA含量与抗-HCV同时检测可提高临床对丙型肝炎的诊断。HCV RNA是反映HCV复制的可靠指标,结合ALT的结果可帮助临床了解HCV在体内的复制状况及肝脏的炎症状态。FQ-RT-PCR法检测HCV RNA具有非常好的临床应用价值。

Objective To evaluate the relationship of Hepatitis C Virus RNA（ HCV RNA） and Antibody of HCV（Anti- HCV） and Alannine Aminotransferase （ALT）. Methods Eighty-three hospitalized hepatitis C patients and 95 healthy contrds were enrolled in this study. HCV RNA was auantitafed fluorescent quantitative reverse transcription polymerase chain reaction （FQ-RT-PCR） Anfi-HCV was defecfed by enzyme linked immunosorbent assay （ELISA） and ALT level was measured by automatic sphacelater , Results There were 67 cases with quantitation of HCV RNA higher than 80copy/ml, Sixty-four patients were positive, Anti-HCV There was sianificant correlation（ r = 0,587, P = 0.002）ibetween HCV RNA and anti-HCV ;58 cases of 83 were abnormal in ALT and abnormal rate increase with increasing quantitaion of HCV RNA. The rate of abnormal cases of ALT was significantly different from the normal cases, ALT level did not correlate with quantitation of HCV RNA;The abnormal rate of ALT was closel correlated with quantitation of HCV RNA（ r = 0.903, P = 0.036）. Conclusion Simultaneous measuement of the quantitation of HCV RNA and Anti-HCV improves clinical diagnosis of Hepatitis C,HCV RNA is a reliable marker of replication.ALT level reflects replication status and inflammation state of the liver, HCV RNA detected by FQ-RT-PCR is clinically pratical.