慢性HBV感染儿童外周全血细胞及肝功能特点分析

Characteristics of peripheral blood cells and liver function of children with chronic hepatitis B

目的探讨慢性HBV感染儿童外周全血细胞指标、肝功能与HBV感染状态关系,为临床诊治儿童慢性HBV感染提供参考。方法回顾性调查127例慢性HBV感染(分为免疫耐受期和低复制期)儿童外周全血细胞指标、肝功能指标及HBVDNA水平。将调查对象按照年龄段分为低龄儿童组(年龄<5岁)和大龄儿童组(年龄≥5岁),在各自年龄段内比较上述指标在免疫耐受组和低复制组间差异,并与49例健康儿童(健康对照组)对照。结果在低龄儿童中,低复制组的RBC计数明显低于免疫耐受组和健康对照组(P均<0.05),但是后2组间差异无统计学意义(P>0.05)。在大龄儿童中,免疫耐受组和低复制组的淋巴细胞绝对值显著低于健康对照组(P<0.05),但是前2组之间的淋巴细胞绝对值差异无统计学意义(P>0.05)。在所有年龄段儿童中,外周全血其他指标在3组之间差异无统计学意义。在低龄儿童中,免疫耐受组和低复制组ALB低于健康对照组。所有慢性HBV感染患儿的ALT、AST都显著高于健康对照组(P均<0.05)。结论在慢性HBV感染的低龄儿童中,低复制组外周血红细胞数降低;大龄儿童的淋巴细胞数减少;低龄患儿ALB、TP下降;所有患儿ALT、AST升高。

Objective To investigate the association between the changes of peripheral blood cell parameters and liver function markers and the state of HBV infection in children with chronic hepatitis B （CHB）, and provide evidence for the diagnosis and treat- ment in CHB children. Methods Peripheral blood cell parameters, liver function markers and HBV DNA levels of 127 CHB child- ren in immunological tolerance period and low replication period were analyzed retrospectively. Those markers of the patients in immunological tolerance period and in low replication period in both younger children group （less than 5 years old） and older children group （5 years old or more） were compared respectively. Forty-nine healthy children were enrolled as controls. Results In younger children group, the counts of red blood cells （RBC） of the children in low replication period were significantly lower than those of the children in immunological tolerance period and those of healthy controls （P〈0.05）, but the difference was not significant between the children in immunological tolerance period and healthy controls （P〉0.05）. In older children group, the absolute counts of lymphocytes of the children in immunological tolerance period and in low replication period were significantly lower than those of healthy controls （P〈O.05）, but the difference was not significant between the children in immunological tolerance period and in low replication period （P〉0.05）. The other peripheral blood cell parameters were not significantly different among the children in immunological tolerance period, those in low replication period and healthy controls. As compared with healthy controls, ALB was significantly lower in the child- ren in immunological tolerance period and in low replication period in younger children group （P〈0.05）, and ALT and AST were sig- nificantly higher in all the CHB children. Conclusions RBC counts decrease in the children in low replication period in younger children group. The absolute counts of lymphocytes decrease in older children group. ALB and TP decrease in younger children group. ALT and AST increase in all the CHB children.