RBP、HBV DNA和ALB联合检测在监测慢性乙肝患者肝损害的应用意义

Application Significance of Joint Detection of RBP,HBV DNA and ALB in Monitoring the Liver Damage in Patients with Chronic Hepatitis B(CHB)

目的通过检测慢性乙肝患者(CHB)血清中视黄醇结合蛋白(RBP)、HBV DNA载量和白蛋白(ALB)的变化,研究上述指标在监测肝损害的相关意义及临床价值。方法收集我院402例慢性乙肝患者的血清标本,根据临床分型分为e--CHB组和e+-CHB组。测定血清RBP、HBV DNA载量和ALB水平关系。结果 1HBV DAN:e--CHB组载量(5.04±1.55)比e+-CHB组载量(6.83±1.48)低(t=11.73,P<0.01),有统计学意义。2血清RBP和ALB水平:e--CHB组(RBP:14.37±11.07;ALB:30.85±8.9)比e+-CHB组(RBP:17.12±8.28;ALB:32.24±4.26)低(t=2.85,P<0.05;t=2.06,P<0.05),有统计学意义。3e--CHB组随着HBV DNA载量的升高血清RBP和ALB水平不断降低,高、中拷贝组与低拷贝组比较有统计学意义(P<0.05);而e+-CHB组HBV DNA载量变化与血清RBP和ALB水平变化关系不明显。结论根据慢性乙肝患者(CHB)临床分型,血清HBV DNA载量水平与RBP和ALB水平存在不同的动态变化。对于e+-CHB患者HBV DNA载量变化与上述肝脏损害指标无显著相关性。e--CHB患者HBV DNA载量变化与肝脏损程度明显相关。另外,血清RBP比ALB更能体现肝功能的损害水平,在肝功能损害上RBP优于ALB。

Objective Through the detection of changes of serum RBP, HBV DNA load and ALB in patients with CHB, we research the related significance and clinical value of the above indicators in monitoring liver damage. Methods We collected serum specimens of 402 cases of CHB patients, and divided into e--CHB and e＋-CHB group according to clinical classification to determine the level relations of serum RBP, HBV DNA load and ALB. Results The results showed that the HBV DNA load of e--CHB group （5.04±1.55） was lower than that of e＋-CHB group （6.83±1.48） （t=11.73, P〈0.01）, which was of statistical significance. The levels of serum RBP and ALB of e--CHB group （RBP：14.37±11.07;ALB：30.85±8.9） were lower than those of e＋-CHB group （RBP：17.12±8.28;ALB：32.24±4.26） low （t=2.85, P〈0.05;t=2.06, P〈0.05）, which were of statistical significance. The levels of serum RBP and ALB of e--CHB group decreased while HBV DNA load increased. The high and medium copy groups were more statistically significant compared with low copy group （P〈0.05）. And changes of HBV DNA load of e＋-CHB group were not obvious with the changes of serum RBP and ALB. Conclusions According to the clinical classification of patients with CHB, serum HBV DNA load level has different dynamic change with RBP and ALB. For e＋-CHB patients, HBV DNA load change has no significant relation with RBP and ALB. For e--CHB patients, HBV DNA load change significantly associates with the degree of liver damage. In addition, the serum RBP can better reflect the damage level of liver function than ALB. In the liver function damage, RBP is superior to ALB.