慢性乙型肝炎患者肝胃不和证与胃粘膜HBsAg和HBcAg相关性研究

The correlation of incoordination between the liver and stomach syndrome of chronic hepatitis B and HBsAg,HBcAg in gastric micosa

目的:探讨慢性乙型肝炎患者肝胃不和证与胃粘膜乙型肝炎病毒标志物(HBsAg,HBcAg)免疫组化之间的相关性,为规范慢性乙型肝炎肝胃不和证提供依据。方法:选择符合条件患者60例。空腹采集血液标本,检测肝功能,HBV DNA定量;并进行电子胃镜检查,取胃窦、胃体、胃底粘膜各1块,活检胃粘膜HBsAg和HBcAg,免疫组化SP法检测阳性率,综合分析各检测值对肝胃不和证积分的意义。结果:60例患者胃粘膜HBsAg、HBcAg检出阳性率分别为55%和90%。胃粘膜HBsAg、HBcAg表达水平与肝胃不和证症候总分呈显著正相关(r=0.702、0.428,均P<0.01)。通过直线相关分析,ALT、TBil与中医症候积分呈正相关(r=0.293、0.324,均P<0.05);AST、A/G与之相关性不强(r=0.204、-0.039,P>0.05)。血清HBV DNA(Copies/ml)对数值与中医症候积分呈正相关(r=0.390,P<0.01)。经过比较,胃粘膜HBsAg、HBcAg免疫组化表达水平与肝胃不和症候总分相关性最强。结论:慢性乙型肝炎患者肝胃不和证与其胃粘膜HBsAg、HBcAg免疫组化表达水平有关。

Objective： To discuss the correlation of incoordination between the liver and stomach syndrome （IBLSS） of chronic hepatitis B （CHB） and HBV marks （HBsAg and HBcAg） immunohistochemical express in gastric mucosa, and supply evidence for the normalization of IBLSS of CHB. Methods： Sixty CHB patients with IBLSS were selected, the empty stomach blood was examined, hepatic function was detested. The HBV DNA in serum was measured with fluorescence quantitative polymerase chain reaction （FQ-PCR）, and by electronic gastroscopy examination to take one tablet mucosa respectively at gastric antrum, gastric body and gastric fundus, by SP to detect HBsAg and HBcAg in gastric mueosa The significance of the test numbers to CHB with IBLSS were analysed. Results： Positive rates of HBsAg and HBcAg in gastric mucosa were 55% and 90% , HBsAg and HBcAg in gastric mucosa had significantly positive correlation with IBLSS of CHB syndrome nubmers （r=0.702, 0.428, P 〈 0. 01 ） . ALT and TBil had positive correlation with IBLSS of CHB syndrome nubmers （ r = 0.293, 0.324, P 〈 0.05 ） ; AST and A/G had no significantly positive correlation with it （ r = 0. 204, - 0. 039, P 〉 0.05 ） . HBV DNA （ Copies/ ml） in serum had positive correlation with it （ r = 0. 390, P 〈 0.01 ）, HBsAg and HBeAg in gastric mucosa had the most significantly positive correlation with IBLSS of CHB syndrome numbers. Conclusion： IBLSS of CHB have significantly positive correlation with HBsAg and HBcAg immunohistochemical express in gastric mucosa.