摘要
目的探讨慢乙肝患者的乙肝五项(HbsAg、HbsAb、HbeAg、HbeAb、HbcAb)、乙肝DNA(HBV-DNA)和甲状腺参数(TSH、FT_3、TT_3、FT_4、TT_4)的临床意义。方法收集在本院2014年6月至2014年12月住院的慢乙肝患者106例,其中慢乙肝轻度患者29例(慢乙肝轻度组)、慢乙肝中度患者57例(慢乙肝中度组)、慢乙肝重度患者20例(慢乙肝重度组)和正常体检者为30例(对照组)。检测其血清的HbsAg、HbsAb、HbeAg、HbeAb、HbcAb、HBV-DNA、TSH、FT_3、TT_3、FT_4、TT_4,并进行统计分析。结果(1)慢乙肝组的TT_3、FT_4、TT_4与对照组相比,差异明显有统计学意义(P<0.001);TSH、FT_3无明显变化(P>0.05)。(2)FT_4、TT_4在慢乙肝轻度组、慢乙肝中度组、慢乙肝重度组和对照组中比较,差异具有统计学意义(P<0.001);慢乙肝重度组的TT_3与轻度组和中度组比较差异有统计学意义(P<0.05)。FT_4在慢乙肝随病情的轻重呈现降低的趋势,慢乙肝重度组和中度组的FT_4水平均低于对照组(P<0.05)。TT_4在慢乙肝加重呈现升高的趋势,但是升高不明显;慢乙肝三组和对照组相比,差异有统计学意义(P<0.05)。(3)慢乙肝组中,TT_3在大三阳组和小三阳组差异有统计学意义(P<0.05)。在DNA≤20IU/mL,大、小三阳两组中的所有检测项目差异不具有统计学意义(P>0.05);在DNA>20 IU/mL中,大、小三阳两组中的TT_3差异具有统计学意义(P<0.05),其余的项目差异不具有统计学意义(P>0.05)。进一步分析TT_3在慢乙肝中度组中的表达,提示在DNA阳性(>20 IU/mL)且大三阳的慢乙肝中度患者的TT_3水平明显高于小三阳(P<0.05)。结论慢乙肝患者血清TT_3和FT_4水平随病情的加重呈现明显降低,与大小三阳无直接关系。DNA阳性(>20 IU/mL)的大三阳慢乙肝中度患者的血清TT_3水平高于DNA阳性的小三阳组。通过检测和监测慢乙肝中度患者的甲状腺激素水平,有助于评估患者的病情和预后判断。
Abstract：Objective To explore the five serdogical markers of hepatitis B （HbsAg HbsAb HbeAg, HbeAb HbcAb）, HBV DNA and thyroid parameters （TSH, P-T3 and TT3, P-T4, TT4 ） in patients with chronic hepatitis B. Methods We collectedl06 cases of chronic hepatitis B patients in hospital, including 29 patients with mild chronic hepatitis B （CHB mild group） and 57 patients with moderate chronic hepatitis B （CHB moderate group）, 20 patients with chronic hepatitis B severe chronic hepatitis b （severe group） ; and normal physical examination for 30 cases （control group） in our hospital from June 2014 to December 2014. Detect the HbsAg, HbsAb, HbeAg HbeAb HbcAb, HBV-DNA, HCV-RNA, TSH, FT3 and TT3, FF4, TT4 in their serum, then performed statistic analysis. Results （ 1 ） Compared with control group, TT3 , FT4, TT4 in CHB group, were significant different（ P 〈 0. 001 ） ; but not for TSH and FT3 （ P 〉 0.05 ）. （ 2 ） Compared to control group, FT4, TT4 in CHB with mild and moderate group and severe group were significantly different, （P 〈 0. 001 ） ; Compared with mild and moderate group, TT3 of Chronic hepatitis Bsevere group was significantly （ P 〈 0.05 ）. FT4 reduced in chronic hepatitis Bwith the reduce of the condition, the FT4 levels in treatment of chronic hepatitis Bof severe and moderate group are lower than the control group （ P 〈 0.05 ）. TT4 in worsen CHB showed a trend of increase, but significant; In chronic hepatitis B, compared three group and the control group, the difference was statistically significant （ P 〈 0. 05 ）. （ 3 ） There is statistically significant with TT3 between E antigen positive chronic hepatitis Bgroup and E antibody positive chronic hepatitis B group （P 〈 0.05 ） in CHB group. When DNA≤〈20IU/mL, all the test items in the two groups had no difference （ P 〉 0. 05 ） ; when DNA 〉 20 IU/mL, TT3 differences in two groups was statistically significant （ P 〈 0.05 ）, the rest of the items are not significantly different （ P 〉 0.05 ）. With further analysis of TT3 expression in chronic hepatitis Bin the moderate group, in DNA positive （ 〉 20 IU/mL） and E antigen positive chronic hepatitis B group with moderate, levels of TT3 were significantly higher than E antibody positive chronic hepatitis B group （ P 〈 0.05 ）. Conclusion Serum TT3 and FT4 levels in Chronic hepatitis B patients were significantly lower along with the serious of the illness, and has no direct relation with whether E antigen positive chronic hepatitis B group or E antibody positive chronic hepatitis Bgroup. The TT3level of patients withDNA positive （ 〉 20 IU/mL） of the E antigen positive chronic hepatitis Bgroup with is higher than E antibody positive chronic hepatitis B group. Through the detection and monitoring of chronic hepatitis B patients with moderate levels of thyroid hormone canhelp to assess the patient＇s condition and prognosis.
出处
《标记免疫分析与临床》
CAS
2017年第5期559-563,共5页
Labeled Immunoassays and Clinical Medicine
基金
河北省医学重点科技研究计划(20160330)
