乙肝病毒表面大蛋白在慢性乙型肝炎肝纤维化诊断中的应用探讨

Study on the Value of the LHBs in Diagnosing Chronic Hepatitis B Cirrhosis

目的 探讨慢性乙型肝炎各个阶段乙肝病毒表面大蛋白（LHBs）含量与肝纤维化指标的关系.方法 选取HBeAg（-）患者42例（其中肝炎患者20例,肝硬化患者22例）,HBeAg（＋）患者38例（其中肝炎患者20例,肝硬化患者18例）,检测其LHBs水平及肝纤维化指标水平（HA,LN,PC-III和IV-C）,并与20例健康成人进行比较,分析各指标的变化特点及相关性.结果 ①肝炎组明显高于正常对照组（t=8.825,P=0.000）,肝硬化组明显高于正常对照组（t=13.003,P=0.000）,肝炎组与肝硬化组差异均有统计学意义（t=0.648,P=0.521）②其中HBeAg（-）肝炎组明显低于肝硬化组（t=40.61,P=0.000）,而HBeAg（＋）肝炎组与肝硬化组差异无统计学意义（t=0.643,P=0.524）;四项纤维化指标HBeAg（-）和HBeAg（＋）肝硬化组均明显高于肝炎组（P〈0.05）.③HBeAg（-）组LHBs和HA,PC-III之间存在线性相关（P〈0.05）;HBeAg（＋）组LHBs和肝纤维化指标之间不存在线性相关（P〉0.05）.结论 LHBs可以预测HBeAg（-）患者的肝纤维化的发生,并且在一定程度上反映HBeAg（-）患者的肝纤维化程度,但是在HBeAg（＋）患者LHBs不能反映肝脏纤维化的程度.

Objective To explore the change of the hepatitis B surface protein （LHBs） in the stages of chronic hepatitis B,and the relationship between LHBs and the index of liver fibrosis. Methods Selected 42 HBeAg（ - ） （20 chronic hepatitis B and 22 cirrhosis）, 38 HBeAg（4-）（20 chronic hepatitis B and 18 cirrhosis） and 20 healthy adults,tested their LHBs level and the index of liver fibrosis （HA, LN, PC-Ⅲ and Ⅳ-C）. Then analysed of the data. Results （1） Hepatitis group was obviously higher than that of normal control group （t= 8. 825, P= 0. 000）,liver cirrhosis group was obviously higher than that of normal control group （t= 13. 003 ,P=0. 000） ,the difference between hepatitis group and liver cirrhosis group was not statistically significant （t= 0. 648, P= 0. 521）. （2）The HBeAg（- ） hepatitis group was significantly lower than the liver cirrhosis group （t = 40. 61, P= 0. 000）, and the difference between HBeAg （＋） hepatitis group and liver cirrhosis group was not statistically significant （t= 0. 643, P= 0. 524）. Four fibrosis index of HBeAg （-） and HBeAg（＋） cirrhosis group were significantly higher than that of hepatitis group （P〈0. 05）. （3）Analysis of the HBeAg（-） group obtained.. LHBs and HA and PC-Ⅲ was positively correlated （P〈0. 05） ;there＇s no correlationship between LHBs and index of liver fibrosis in HBeAg （＋） group. Conclusion LHBs can predict HBeAg（-） patients＇ liver fibrosis and reflect the degree of liver fibrosis to some extent. But LHBs cannot reflect the liver fibrosis in HBeAg（＋） patients.