乙型肝炎肝硬化患者HBV血清学模式与病毒载量关系的研究

The study of the relationship between serum model and viral load of HBV in hepatitis B patients with liver cirrhosis

目的通过分析乙型肝炎肝硬化患者HBV血清学模式、HBV DNA、肝功能,探讨乙型肝炎肝硬化患者抗病毒治疗的临床意义。方法回顾性分析168例乙型肝炎肝硬化患者的病史、血清病毒学指标、肝功能,按不同的指标进行分组、比较。结果168例乙型肝炎肝硬化患者中以HBV DNA阳性者占绝大多数(91.0%),其中HBeAg阴性者占81.0%;分组比较提示HBV DNA阳性组ALT、AST显著高于阴性组,ALT异常组HBV DNA载量明显高于ALT正常组(P<0.01);不同Child-Pugh分级之间HBV DNA载量无显著性差异。结论乙型肝炎肝硬化住院患者以HBV DNA阳性及HBeAg阴性者居多,HBV DNA呈较高水平复制者,肝脏炎症损害亦较重,故应及早予以抗病毒治疗。

Objective To explore the clinical value of the antiviral treatment in hepatitis B patients with liver cirrhosis by analyzing serum model, HBV DNA expression and liver function. Methods A retrospective analysis was conducted in 168 patients with HBV-related liver cirrhosis, in which the case history, serum HBV markers and hepatic function were observed, and indicators were compared in different groups. Results Among 168 hepatitis B patients with liver cirrhosis, HBV DNA positive patients accounted for the overwhelming majority （91.0%）, 81.0% of whom were HBeAg negative. It was indicated that ALT and AST of HBV DNA positive patients were significantly higher than those of the negative group. HBV DNA load of patients with abnormal ALT was significantly higher than that of patients in the normal group （P〈0.01）. There was no difference in HBV DNA load of different Child-Pugh levels. Conclusion Among hepatitis B patients with liver cirrhosis, HBV DNA positive and HBeAg negative patients were the majority. Liver inflammation does more harm to patients with higher HBV DNA replication, therefore, antiviral therapy should be conducted as early as possible.