HBV病毒载量与血清学标志物和肝功能关系的分析

Analysis of the Relationship Between HBV Vious Load Capacity,Serum Markers and Liver Function

目的:探讨血清HBV病毒载量与血清学标志物和肝功能之间的关系。方法:用实时荧光定量PCR法测定乙肝病毒载量、ELISE法测定血清学标志物及酶法测定肝功能指标ALT、AST,对5486例乙肝患者血清标本的上述三种指标结果进行分析。结果:在四种常见的血清学模式中,HBeAg阳性的Ⅰ组(HBsAg、HBeAg和Anti-HBc阳性)和Ⅳ组(HBsAg和HBeAg阳性)的HBV病毒载量阳性率为94.8%,明显高于HBeAg阴性的Ⅱ组(HBsAg、Anti-HBe和Anti-HBc阳性)和Ⅲ组(HBsAg和Anti-HBc阳性)38.5%的阳性率,并且在不同的HBV病毒载量拷贝数组中,HBeAg阳性率随着HBV病毒载量拷贝数的增加而升高;血清学模式为Ⅰ、Ⅱ和Ⅲ组病人的肝功能异常率在HBV病毒载量<103copies/ml和>103copies/ml两组中在统计学上均有显著性差异(P<0.01),提示上述三组血清学模式病人中,HBV病毒载量为>103copies/ml组的肝功能异常率与<103copies/ml组比较明显偏高;而Ⅳ组在HBV病毒载量两组中的肝功能异常率在统计学上无显著性差异(P>0.01)。结论:HBV病毒载量与乙肝血清学标志物及肝功能指标ALT、AST之间有一定程度的关联,但又各有特点,临床上只有对三类检测结果进行综合分析,才能更好地对HBV感染的诊断、治疗和预后判断提供帮助。

Objective：This article aims at discussing the correlativity of hepatitis B virus load （HBV - DNA）, serum markers and liver function. Methods： We detected the hepatitis B virus load by FQ- PCR, HBV scram markers by ELISE and liver function （ALT＆AST） by enzyme analysis of 5 486 serum samples of patients who have infected hepatitis B virus, and then discuss the correlativity of these three items. Results： In four kind of common HBV serology patterns, the positive rate of HBV - DNA in HBeAg positive patients （94.8% ） was obviously higher than those in HBeAg negative patients （38.5% ）, and in different HBV - DNA copy number groups, the positive rate of HBeAg increased obviously along with the HBV - DNA copy number increased; Between HBV - DNA 〈 103 copies/ml group and 〉 103 copies/ml group, the abnormal rate of liver function （ALT＆AST） for patients which the HBV serology pattern was group Ⅰ , Ⅱ and Ⅲ, all had significant difference in statistic （ P 〈 0.01 ）, but for patients which the HBV serology pattern was group IV, the abnormal rate of liver function （ALT＆AST） between two HBV- DNA groups had no difference in statistic （ P 〉 0.01 ）. Conclusion： There is a certain correlation among hepatitis B virus load, serum markers and liver function, but respectively has the characteristic.