乙型肝炎血清HBV-DNA含量与肝纤维化、实质病变程度的关系

The relationship of serum HBV-DNA level,liver fibrosis and the pathological degree of liver parenchyma in hepatitis B

目的探讨慢性乙型病毒性肝炎患者不同肝纤维化分期的肝实质内HBV-DNA的复制状态。方法85例慢性乙型病毒性肝炎患者均同期接受血清HBV-DNA核酸扩增（PCR）荧光定量、肝活检组织学肝纤维化分期及B型超声波仪测量肝脏径线。结果肝组织肝纤维化分期从S1～S4期，患者血清HBV-DNA定量、右肝斜径和左肝上下径的均数值均呈趋势下降，差异具有统计学意义（P〈0．05），不同分期HBV-DNA含量两两比较，S1期与S4期、S2期与S4期差异有统计学意义（P〈0．05），S1期与S2、S2期、S3与S2、S4期差异无统计学意义（P〉0．05）。将HBV-DNA定量及其肝实质系数（右肝斜径和左肝上下径乘积）联合考虑，相同量系数的肝实质所承担产生血清HBV-DNA数量的差异无统计学意义（P〉0．05）。结论慢性乙型肝炎不同纤维化分期中“健存”肝细胞内HBV-DNA的复制状态可能并无改变，患者血清HBV-DNA含量下降与提供HBV-DNA复制场所的肝细胞总量减少有关。

Objective To study the serum hepatitis B virus DNA （HBV-DNA） replication level apportioned by the same hepatic parenchyma cell volume at hepatic fibrosis stages 1 - 4 in patients with chronic hepatitis B （CHB）. Methods Eighty-five patients with CHB were enrolled in this study and examined three items in correspond period, including quantification detection of HBV-DNA, liver specimens fibrosis stages and the diameters of liver measured by ultrasound-graphy type B. Results From S1 to S4 , the means of serum HBV-DNA level, the oblique diameter of the hepatic right lobular （OD） and the superior inferior diameter of the hepatic left lobular （SID） were all.declining trends and had statistical significance （P 〈 0.05）. To serum HBV-DNA levels, significant differences were found between these stages （P〈0.05） ： S1 and S4; S2 and S4. There was no significant difference （P 〉0.05） ： compared S3 with S1, S2 or S4; between S1 and S2. Serum HBV-DNA quantification in same liver parenchyma coefficient among hepatic fibrosis stages 1 - 4 was not statistical significance （P 〉 0.05）. Conclusion Following the progression of hepatic fibrosis from stage 1 to 4, the status of HBV-DNA replication in alive hepatocytes may not change. The decrease of serum HBV-DNA level is related with the decline of hepatic parenchyma cell volume.