乙型肝炎病毒患者血清腺苷脱氨酶的应用价值探讨

Clinical Significance of Adenosine Deaminase Level in Serum of Hepatitis B Virus Infected Patient of Different Positive Marker

目的探讨检测乙型肝炎病毒(HBV)标志物不同阳性类型患者的血清腺苷脱氨酶(ADA)的临床应用价值。方法用速率法测定血清ADA水平;用酶联免疫吸附试验(ELISA)法测定乙型肝炎病毒血清标志物(俗称“二对半”);用荧光定量PCR检测HBVDNA。按HBV标志物阳性情况将患者分为3组:A组50例,为HBsAg、HBeAg、HBcAb阳性(俗称“大三阳”),HBVDNA阳性;B组54例,为HBsAg、HBcAb阳性,HBVDNA阳性或阴性;C组94例,为HBsAg、HBeAb、HBcAb阳性(俗称“小三阳”),HBVDNA阳性或阴性。全部患者均检测其血清ADA水平。正常对照组60例。结果血清ADA水平由高到低依次为A组、B组、C组、正常对照组,差异有显著性(P<0.05),B组和C组中的HBVDNA阳性患者均高于HBVDNA阴性患者,有显著性差异(P<0.05),A组的血清ADA水平略高于B组中的HBVDNA阳性患者,无显著性差异(P>0.05)。结论血清ADA水平是反映肝细胞损害的一个良好指标,乙型肝炎病毒患者或携带者血清ADA在一定程度上反映HBV的复制情况,其水平测定对指导临床治疗有重要意义。

Objective To explore the value of adenosine deaminase（ADA） level in serum of hepatitis B virus infected patient of different positive marker. Methods Serum ADA level, hepatitis B virus serum marker, and HBV DNA were detected by using rate method, ELISA method, and FQPCR respectively. The patients were divided into three groups of serum marker patterns. HBsAg, HBeAg, HBcAb, and HBV DNA were all positive in group A （50 cases）; HBsAg and HBcAb were positive, but HBV DNA was positive or negative in group B （.54 cases） ; HBsAg, HBeAb, and HBcAb were positive, but HBV DNA was positive or negative in group C （94 cases）. The levels of serum ADA were measured in all patients. Another 60 healthy persons were recruited as the control group. Results The levels of serum ADA from high to low were groups A, B, C, and the healthy control （P〈 0.05）. The serum ADA levels of the HBV DNA positive patients were significantly higher than those of the HBV DNA negative patients in the groups B and C （P〈 0.05）. The serum ADA levels in group A patients were slightly higher than those of the HBV DNA positive patients in group B, but showed no significant difference （P 〉 0.05）. Conclusions The serum ADA level of hepatitis B virus infected patient can be used as an index of treatment effectiveness evaluation, and it is of great value to working out the effective healing solution.