乙肝患者检测血浆D-D二聚体及HBV-DNA的临床意义

Detection of Hepatitis B Patients and Clinical Significance of Plasma D-dimer of HBV-DNA

目的探讨分析血浆D-D二聚体在HBV-DNA阳性的乙型肝炎患者中的反应表达,并对其临床意义进行探讨。方法收集吉林大学第四医院一汽总医院2015年1月—2016年1月门诊及感染病房160例乙型肝炎患者血清样本。用实时荧光PCR技术检测HBV-DNA将其HBV-DNA将其阳性标本按临床诊断分急性乙肝组、慢性乙肝组作为对照组。按其HBV-DNA载量数分5组。同时抽取50名健康人血清样本作为对照组,均测定其血浆D-D二聚体的水平,进行对比分析。结果 HBV-DNA阳性的乙肝患者中,肝硬化组D-D二聚体(3.86±2.42)μg/mL明显高于健康对照组(0.42±0.33)μg/mL、急性乙肝组(1.12±0.98)μg/mL、慢性乙肝组(2.91±2.14)μg/mL,差异均有统计学意义(P<0.05)。而HBV-DNA不同载量组之间血浆D-D二聚体水平分别为(1.03±0.98)、(1.21±0.79)、(1.16±1.02)、(1.27±1.11)、(1.32±1.01)μg/mL,组间比较,差异无统计学意义(P>0.05)。结论血浆D-D二聚体检测客观反映乙肝患者凝血和纤溶的状况,评估肝脏功能受损严重程度。有利于乙型肝炎患者的病情进展情况检测及治疗效果的评估,而与其HBV-DNA载量数多少无相关表达。

Objective To observe the plasma D- D dimer in HBV- DNA positive reaction expression of hepatitis b patients, and to discuss its clinical significance. Methods 160 cases of hepatitis B patients were selected from January2015 to January 2016 in the fourth hospital of Jilin University,With real-time fluorescence PCR technique to detect HBV- DNA to HBV- DNA its positive specimens points according to the clinical diagnosis of acute hepatitis, chronic hepatitis b group as control group. According to the HBV- DNA loads for five times. A control group of 50 cases of healthy human serum samples at the same time, both the determination of the plasma D- D dimer level, were analyzed. Results HBV-DNA positive patients with chronic hepatitis B, cirrhotic patients and D-D dimer μg/mL（3.86±242]） were significantly higher than those in healthy control group（0.42±0.33） μg/mL, acute hepatitis B group（1.12±0.98） μg/mL, the group of chronic hepatitis B（2.91±2.14） μg/mL, the differences were statistically significant（P〈0.05）.But HBV-DNA different load group between plasma D-D dimer level respectively（1.03±0.98）,（1.21± 0.79）,（116±1.02）,（1.27±1.11）,（1.32±1.01）μg/mL groups no significant difference, and had no statistical significance（P〉0.05）. Conclusion The detection of plasma D- D dimer objectively reflect the condition of hepatitis b patients blood coagulation and fibrinolysis, assessment of liver function damage severity. Is conducive to the progress of the disease detection and treatment of patients with hepatitis b effect evaluation, and how many no associated with HBV- DNA loads.