乙型肝炎病毒不同临床感染阶段乙型肝炎表面抗原水平分析

Analysis of the levels of serum hepatitis B surface antigen in different clinical stages of hepatitis B ;virus infection

目的：探讨乙型肝炎病毒（HBV）感染不同临床阶段血清乙型肝炎表面抗原（HBsAg）水平变化及其与血清HBV DNA水平相关性。方法选择HBsAg阳性未经抗病毒治疗的患者575例，其中免疫耐受（IT）期120例（IT组）、乙型肝炎e抗原（HBeAg）阳性慢性乙型肝炎（EPH）110例（EPH组）、低复制（LR）期90例（LR组）、HBeAg阴性慢性乙型肝炎（ENH）110例（ENH组）、肝炎肝硬化（LC）85例（LC组）及肝细胞癌（HCC）60例（HCC组）。对其血清HBsAg、HBV DNA水平进行检测及统计学分析。结果 IT组、EPH组、LR组、ENH组、LC组及HCC组血清HBsAg水平分别为（4.58±0.40）、（4.12±0.50）、（2.60±0.68）、（3.31±0.27）、（2.82±0.57）、（3.03±0.39） lg U/ml，差异有统计学意义（P＜0.01）。IT组、EPH组、LR组、ENH组、LC组及HCC组血清HBsAg水平与血清HBV DNA水平呈正相关性，r值分别为0.627、0.579、0.134、0.317、0.159及0.224。结论慢性乙型肝炎不同临床感染阶段血清HBsAg水平存在显著差异，其与血清HBV DNA水平的相关性在总体上呈逐渐减弱趋势。

Objective To explore the levels of serum hepatitis B surface antigen （HBsAg） in different clinical stages of hepatitis B virus（HBV） infection and their correlation with serum HBV DNA. Methods Five hundred and seventy-five patients with HBsAg-positive and without antiviral therapy were enrolled in this study. The patients were classified into six group：IT group （immune tolerant phase, 120 patients）, EPH group （hepatitis B e antigen positive hepatitis, 110 patients）, LR group （low replicative phase, 90 patients）, ENH group （hepatitis B e antigen negative hepatitis, 110 patients）, LC group （liver cirrhosis stage, 85 patients） and HCC group （hepatocellular carcinoma, 60 patients）. Serum HBsAg and HBV DNA levels were quantified and analyzed through statistics. Results The levels of serum HBsAg in IT group, EPH group, LR group, ENH group, LC group and HCC group were （4.58 ± 0.40）, （4.12 ± 0.50）, （2.60 ± 0.68）, （3.31 ± 0.27）, （2.82 ± 0.57） and （3.03 ± 0.39） lg U/ml respectively, and there was significantly different among the different phase （P〈0.01）. The levels of serum HBsAg in IT group, EPH group, LR group, ENH group, LC group and HCC group had positive correlation with serum HBV DNA level, and the correlation coefficients were 0.627, 0.579, 0.134, 0.317, 0.159 and 0.224 respectively. Conclusions The levels of serum HBsAg is significantly different in the different clinical phase of HBV infection, and the tendency of the correlation between serum HBsAg and serum HBV DNA gradually weakens in general.