HCV RNA检测与血清病毒学的关系及临床意义分析

Clinical Significance and Relationship between HCV RNA and Other Serological Markers in Patients Infected with Hepatitis C

目的:探讨丙型肝炎病毒(HCV)RNA检测在HCV单独感染和HCV、乙型肝炎病毒(HBV)合并感染中的临床意义。方法:对129例HCV感染者检测抗-HCV、HCVRNA和总胆红素(TBiL)、谷丙转氨酶(ALT),并对其中的HCV、HBV合并感染(HBV+HCV组,27例)和HBV单独感染患者(HBV组,50例)检测HBVDNA。结果:129例HCV感染患者中,抗-HCV和HCVRNA同时阳性者占68.2%,抗-HCV阳性而HCVRNA阴性者占27.9%,抗-HCV阴性而HCVRNA阳性者占3.9%。肝硬化和肝癌组的HCVRNA阳性率84.2%(32/38)较慢性肝炎组的67.0%(61/91)升高(P<0.05)。ALT和(或)TBiL均异常的HCV患者HCVRNA阳性率79.8%(71/89)较ALT和TBiL均正常者的55.0%(22/40)升高(χ2=8.42,P<0.01)。在HCV和HBV合并感染组,HCVRNA阳性率55.6%(15/27)低于单纯HCV感染组的76.5%(78/102),差异有统计学意义(P<0.05),HBVDNA的阳性率29.6%(8/27)低于单纯HBV感染组的76.0%(38/50),差异有统计学意义(P<0.01)。结论:在HCVRNA检测的同时,结合多项血清病毒学和一些生化相关指标分析,对HCV感染的临床诊治有重要的指导意义。

Objective： To investigate the clinical significance of HCV RNA in patients infected with HCV and co-infection by HCV and HBV. Methods： One hundred and twenth-nine HCV eases and 50 control subjects were detected for anti-HCV, HCV RNA, totalbilirubin（TBiL）, alanine transamin ase（ALT） and HBV DNA. Results： The positive rates of anti- HCV（＋） and HCV RNA（＋）, anti-HCV（＋） and HCV RNA（-）, anti-HCV（-） and HCV RNA（＋） were 68.2% （88/129）, 27.9% （36/ 129）, and 3.9% （5/129） respectively. The positive rate of HCV RNA in group [liver cirrhosis （LC）＋hepatoeellular carcinoma （HCC）] was higher than that in group chronic hepatitis （CH）. The abnormity rate of ALT and TBiL has a distinct relationship with the positive rate of HCV RNA （P 〈 0.01）. In the group of co-infection by HCV and HBV, the positive rates of HCV RNA and HBV DNA were significantly decreased than those of single HCV and HBV groups （P 〈 0.05, P 〈 0.01）. Conclusion： The HCV RNA assay accompanying tests of other serological markers is useful for the diagnosis and therapy of HCV patients.