HBVM阳性肺结核患者HBVDNA检测的临床意义

The clinical value of measuring HBVDNA for pulmonary tuberculosis patients with HBVM positive

目的探讨HBVDNA(乙型肝炎病毒DNA)、HBVM(乙型肝炎病毒标志物)阳性肺结核患者抗结核治疗时对肝损害的影响。方法肺结核患者HBVM阳性且HBVDNA阳性为观察组A,HB-VM阳性、HBVDNA阴性者为观察组B,HBVM阴性为对照组C,观察各组抗结核药物肝损害发生率、停药率及A组HBVDNA水平与肝损害发生率、停药率有无相关。结果各组肝损害发生率两两比较均有显著性差异(P<0.01);A组停药率与其他两组均有显著性差异(P<0.01),B组与C组无显著性差异(P>0.05);A组HBVDNA水平与肝损害发生率、停药率无相关(P>0.05)。结论HBVM阳性尤其HBVDNA阳性肺结核化疗应重视,HBVDNA阴性者可短程化疗,HBVDNA阳性者都应慎行短程化疗。

Objective To explore the liver injury due to the anti-TB treatment among the HBVDNA, HBVM positive TB. Methods Pulmonary tuberculosis patients with HBVM （Hepatitis B virus Marker） positive and HBVDNA positive were recruited in experimental group A, those with HBVM positive but HBVDNA negative were recruited in experimental group B, those with HBVM negative were recruited as control group C, The prevalence rate of liver injury and withdrawal of anti-tuberculosis drugs and the relationship between HBVDNA level and those rates were observed. Results The prevalent rate of liver injury was statistically different in any of the two groups （P 〈 0.01） ; the rate of withdrawal of group A was higher than other two groups （ P 〈 0.01）, while Group B and group C did not have the difference on the withdrawal （ P 〉 0. 05） ; there were no relationship between HBVDNA level and the prevalent rates of liver injury and withdrawal （ P 〉 0.05） in group A. Conclusion Attention should be paid to the liver injury of the pulmonary tuberculosis with HBVM positive and HBVDNA Those with HBVDNA negative could been treated by short-course chemotherapy. Despite the HBVDNA level, those with HBVDNA positive should been careful treated by short-course chemotherapy.