血清HBV DNA复制与慢性乙型肝炎肝脏损伤程度的研究

RESEARCH BETWEEN THE LEVEL OF HBV DNA IN SERUM AND THE GRADE FO HISTOLIGICAL ACTIVITY IN PATIENTS WITH CHRONIC HEPATITSB

目的 :探讨慢性乙型肝炎急性发作时 ,HBV复制水平与肝脏组织损伤程度之间的关系。方法 :对 44例自发性发作的慢性乙型肝炎患者进行肝组织活检 ,并采用荧光定量多聚酶链反应测定血清HBVDNA含量。结果 :血清HBVDNA含量与肝脏炎症程度 (G1～G4)及纤维化程度 (S1～S4)之间比较 ,无明显相关性 (P >0 .0 5 ) ;与血清丙氨酸转氨酶 (ALT)、门冬氨酸转氨酶 (AST)及总胆红素 (T -BILI)之间也无相关性。结论 :肝细胞损伤程度与不同个体中的HBV复制的绝对数值没有关系。提示HBV不直接致肝细胞病变 ,不同个体复杂的免疫反应决定了肝脏的损伤程度。

Objective: To clarify the relationship between the level of hepatitis B virus DNA (DNA) in serum and the grade of histological activity in the patients with chronic hepatitis B while the hepatic injury was activated. Methods: Forty-four patients proven as chronic hepatitis B patients by liver biopsy in episodes of acute exacerbation were placed into four groups according to their grade of hepatic histological activities. The serum HBV DNA copies were tested by the fluorogenic quantitative polymerize chain reaction (PCR). Results: There were no statistically significant differences in the levels of HBV DNA among G1~G4 groups ( P >0.05) and among S1~S4 groups ( P >0.05) respectively. Rank correlation was not found between the levels of HBV DNA and ALT or aspartate-aminotransferase (AST) or total bilirubin. Conclusions: The hepatitis B virus is not cytopathogenic. The absolute amount of the sera of HBV DNA in patients with chronic hepatitis B does not directly correlate with the grade of hepatitis histological. Complex immune responses in different individuals may determine the variable degree of hepatic injury.