丙型肝炎患者血清丙型肝炎病毒核糖核酸与丙型肝炎抗体及肝功能的检测

Analysis of serum hepatitis C virus,anti-HCV and alanine transaminase:results from patients with hepatitis C

目的对丙型肝炎患者血清中丙型肝炎病毒核糖核酸(HCV RNA)定量检测结果与丙型肝炎抗体(抗-HCV)的检测结果以及丙氨酸转氨酶(ALT)水平进行比较分析,探讨其相关性及临床意义。方法对251例丙型肝炎患者血清标本,采用荧光定量聚合酶链反应(FQ-PCR)技术检测HCV RNA含量,酶联免疫吸附测定(ELISA)法检测抗-HCV,用生化自动分析仪检测ALT值。结果251例丙型肝炎患者血标本均为抗-HCV或HCV RNA阳性,其中:①抗-HCV阳性235例(93.6%);HCV RNA阳性197例(78.5%)。②抗-HCV和HCV RNA同时阳性181例(72.1)%;抗-HCV阳性,HCV RNA阴性54例(21.5%);HCV RNA阳性,抗-HCV阴性16例(6.4%);③ALT异常者164例(65.3%),其中HCV RNA阳性143例,HCV RNA阴性21例;ALT正常87例,其中HCV RNA阳性54例,HCV RNA阴性33例;HCV RNA水平与ALT异常率呈正相关(rs=0.468,P=0.000),而与ALT水平高低无相关性(r=-0.048,P=0.447)。结论抗-HCV和HCV RNA含量的检测在丙型肝炎的诊断中具有重要意义;二者同时检测可以提高临床对丙型肝炎的诊断;丙型肝炎患者HCV RNA水平与ALT异常率呈正相关,而与ALT水平高低无相关性。

Objective To analyize the results of serum hepatitis C virus RNA level, anti-HCV and alanine transaminase（ALT） level in patients with hepatitis C, and to investigate their relationship and clinical significance. Methods Fluorescent quantitative polymerase chain reaction was used to detect the level of serum HCV RNA in 251 patients with hepatitis C; meanwhile, anti-HCV was checked by enzyme linked immunosorbent assay and the level of serum ALT was measured by biochemical instrument. Results The serum of 251 cases was all positive for HCV RNA or anti-HCV,and of these cases.①235 （93.6 %） were positive for anti-HCV and 197 （78.5 %） were positive for HCV RNA. ②181 （72.1%） were positive for anti-HCV and HCV RNA, 54 （21.5%） were positive for anti-HCV but negative for HCV RNA, and 16 were positive for HCV RNA but negative for anti-HCV. ③164 （65.3%） were abnormal for ALT including 143 with positive HCV RNA results and 21 with negative HCV RNA results,and 87 were normal for ALT including 54 with positive HCV RNA results and 33 with negative HCV RNA results. HCV RNA level has positive correlation with the abnormal rate of ALT（ rs= 0. 468, P ： 0. 000）. But there was no correlation between HCV RNA level and ALT level（ r =-0. 048, P =0. 447）. Conclusion Anti-HCV and HCV RNA level are all important to diagnose hepatitis C; Combination of the two parameters is beneficial in diagnosis of hepatitis C; HCV RNA level has positive correlation with the abnormal rate of ALT,but there is no correlation between HCV RNA level and ALT level.