乙肝肝硬化患者血清乙肝病毒表面抗原定量水平的研究

The quantitive level of Hepatitis B surface antigen in patients with HBV-related liver cirrhosis

目的分析不同Child-pugh分级的乙肝肝硬化患者血清乙肝病毒表面抗原(HBsAg)定量检测水平及其在各组间与HBV DNA含量之间的相关性。方法收集乙肝肝硬化患者血清,其中Child-pugh A级38例,B级46例,C级35例,采用雅培化学发光法进行HBsAg定量测定,采用荧光PCR定量法检测HBV DNA含量。结果 HBsAg定量值分别为Child-pugh A级[997.70(146.00～1717 12)IU/mL],Child-pugh B级[1158.78(345.82～1889.93)IU/mL],Child-pugh C级[613.76(120.78～1528 77)IU/mL],三组比较差异无统计学意义(P=0.464)。HBsAg定量与HBV DNA相关性分析:HBsAg定量水平、HBV DNA含量在乙肝肝硬化患者总体中呈正相关(r=0.353,P=0.000),其中Child-pugh A级相关性最高(r=0.410,P=0.011),Child-pugh B级次之(r=0.366,P=0.012),Child-pugh C级则无相关性(r=0.293,P=0.088)。在各组中HBsAg定量水平与ALT、AST和TBIL均无相关性。结论不同Child-pugh分级的乙肝肝硬化患者之间血清HBsAg定量水平无差异;HBsAg定量水平与HBV DNA在Child-pugh A级、B级组具有正相关性,C级组无相关性。

[Objective] To investigate HBsAg quantitive level in different Child-Pugh scores in patients with HBV-related liver cirrhosis （LC） and the correlation with HBV DNA level in each cohort. [ Methods ] HBsAg level and HBV DNA were measured among 38 Child-pugh A cohort, 46 Child-pugh B cohort, 35 Child-pugh C cohort using Abbott chemiluminescence and fluorescence quantitative PCR, respectively. [ Results ] The HBsAg quantitive level in serum was 997.70 IU/mL in the Child-pugh A cohort, 1158.78 IU/mL in the Child-pugh B cohort, 613.76 IU/mL in the Child-pugh C cohort respectively, and there were no statistical difference among these cohorts （P = 0.464）. Correlation analysis between HBsAg level and HBV DNA showed that they had a positive correlation in over- all （11 =0.353, P =0.000）, and the correlation was strongest in the Child-pugh A cohort （r =0.410, P =0.011）, and the correlation in Child-pugh B cohort second （r =0.366, P =0.012）, but no correlation was found in the Child-pugh C cohort （r =0.293, P =0.088）. There was no correlation between HBsAg level and ALT, AST, TBIL level in all cohorts. [ Conclusion ] The level of HBsAg quantity in serum has no difference among different Child-Pugh scores in patients with LC. The level of HBsAg quantity and HBV DNA have a positive correlation in Child-pugh A and B cohort, but no correlation is found in the Child-pugh C cohort.