慢性乙型肝炎患者病理舌苔与血清HBV DNA含量、肝脏HBcAg蛋白表达的关系

Study of the correlation between abnormal tongue coatings of patients with CHB,the serum level of hepatitis B virus,and the expression of HBcAg proteins in liver cells

目的:通过对慢性乙型肝炎(CHB)患者病理舌苔与血清HBV DNA含量、肝脏HBcAg表达的研究,揭示CHB患者病理舌苔与病毒复制的关系,为临床宏观望舌诊病,以外揣内提供理论指导。方法:B超引导下肝脏穿刺,免疫组化法检测CHB患者肝脏HBcAg蛋白表达;荧光定量PCR(FQ-PCR)技术检测CHB患者血清HBV DNA含量。结果:①黄腻苔和白厚苔组CHB患者血清HBV DNA含量最高,与薄白苔组相比,差异有统计学意义(P<0.05)。薄白苔组HBV DNA病毒复制以少量(<105copies/ml)为主(P<0.01)。②黄腻苔和白厚苔组CHB患者肝组织HBcAg阳性细胞率明显高于薄黄苔和薄白苔组(P<0.01),其肝细胞HBcAg分布形态以浆膜型和混合型为主(P<0.05);薄白苔组以单纯核型为主(P<0.01)。结论:CHB患者其舌苔厚薄与病毒载量有一定关系,血清HBV DNA含量高者,肝脏HBcAg阳性细胞率亦较高。

Objective： Through the study of abnormal tongue coatings of patients with CHB, the serum level of hepatitis B virus, and the expression of HBcAg proteins in liver cells, to reveal the relationship between abnormal tongue coatings and replication level of HBV, to provide theory instruction for clinical diagnosis through observing tongues. Methods： Liver tissues were taked with paracentesis, the protein expressions of HBcAg were detected with immunity histochemistry, the serum content of HBV DNA was detected with immunofluorescence polymerase chain quantitation and in situ molecular hybridization technique. Results： ①The serum content of HBV DNA of yellow sticky coating and white thick coating groups of patients with CHB were most high, compared with thin white coating group, there was a significant difference （P 〈 0. 05 ）. The serum copy level of HBV DNA of thin white coating group mainly presented the range of 〈 10^5 copies/ml （P 〈0. 01 ） . ②The positive cell rate of HBcAg expressed in liver cells of yellow sticky coating and white thick coating groups was much higher than that of thin yellow coating and thin white coating groups （P 〈0. 01 ）. Positive cells of HBcAg in liver tissue of yellow sticky coating and white thick coating groups were mainly present whith serous membrane from and mixture form （ P 〈 0. 05 ） ; those of thin white coating group were mainly present whith karyotype （P 〈 0. 01 ）. Conclusions： There is a certain relationship between abnormal tongue coatings of patients with CHB and replication level of HBV, those of higher serum level of HBV DNA, their positive cell rate of HBcAg expressed in liver cells are higher too.