慢性乙型肝炎病毒复制与肝纤维化血清学指标相关性分析

Analysis on the correlation between hepatitis B virus DNA replication and serum markers of liver fibrosis in patients with chronic hepatitis B

目的探讨慢性乙型肝炎患者（chronic hepatitis B,CHB）HBV DNA复制与肝纤维化血清学指标之间的相关性。方法 308例慢性乙型肝炎患者同时接受血清HBV DNA、HBeAg、透明质酸（HA）、Ⅲ型前胶原（PcⅢ）、Ⅳ型胶原（Ⅳ-C）和层粘连蛋白（LN）检测。结果 HBV DNA含量在105～107IU/ml、〉107IU/ml两组肝纤维化血清学四项指标值均高于〈103IU/ml组,差异均有统计学意义（P〈0.05）；HBV DNA含量在105～107IU/ml、〉107IU/ml两组与103～105IU/ml组比较,HA、PcⅢ、Ⅳ-C三项指标值均高于103～105IU/ml组,差异均有统计学意义（P〈0.05）,而LN差异无统计学意义（P〉0.05）；HBV DNA含量〈103IU/ml与103～105IU/ml组比较、105～107IU/ml与〉07IU/ml组比较,肝纤维化四项血清学指标之间差异均无统计学意义（P〉0.05）；当HBV DNA含量〈103IU/ml时,HBeAg阳性组与HBeAg阴性组比较肝纤维化四项指标之间差异无统计学意义（P〉0.05）,当HBV DNA含量高于103IU/ml时,HBeAg阳性组HA、PcⅢ、Ⅳ-C三项指标值均高于HBeAg阴性组,差异有统计学意义（P〈0.05）,而LN差异无统计学意义（P〉0.05）。结论慢性乙型肝炎患者乙肝病毒的复制与肝纤维化血清学指标之间存在一定的相关性,但不呈线性相关。

Objective To explore the relationship between hepatitis B virus DNA replication and serum markers of liver fibrosis in patients with chronic hepatitis B （CHB）. Methods Three hundred and eight patients with CHB were enrolled in this study. All patients＇ serum levels of HBV DNA, hepatitis B e antigen （HBEAG）, hyaluronidase （HA）, procollagen III （Pc Ⅲ）, IV collagen （IV- C） and laminin （LN） were analyzed. Results Four indices of liver fibrosis in sera of CHB patients with HBV DNA 105 - 107 IU/ml and 〉 107 IU/ml were all significantly higher than those in patients with HBV DNA 〈 103 IU/rnl, and the differences were statistically significant （P 〈 0.05 ）. HA, PcIII and IV- C in sera of CHB patients with I-IBV DNA l05 107 IU/ml and 〉 10v IU/ml were all significantly higher than those in patients with HBV DNA 103 - 105 IU/ml, with statisti- cally significant differences （P〈 0.05）, but no statistically significant difference was found in LN （P 〉 0.05 ）. There was no statistically significant difference in the four indices of liver fibrosis in patients with HBV DNA between 〈 103 IU/ml and 103 - 105 IU/ml or between 105 - 107 IU/ml and 〉107 IU/ml （P〉0.05）. No statistically significant difference was found in the four indices of liver fibrosis between ~ positive and HBeAg negative patients with HBV DNA 〈 103 IU/ml （P〉0.05）. Among patients with HBV DNA 〉 103 IU/ml, HA, PclII and IV- C of patients with HBeAg positive were all significantly higher than those in patients with HBeAg negative （P〈0.05）, but no statistically significant difference was found in LN （P 〉0.05）. Conclusions There is a certain correlation between HBV DNA replication and the serological indexes of liver fibrosis in patients with CHB, but no a linear correlation is found between them.