HBV-DNA载量测定联合HBsAg定量分析在慢性HBV感染诊疗中的作用

The role of HBV-DNA load assay combined with HBsAg quantitative analysis in the diagnosis and treatment of chronic HBV infection

目的分析乙型肝炎病毒脱氧核糖核酸(HBV-DNA)载量测定联合乙型肝炎表面抗原(HBsAg)定量分析在慢性乙型肝炎病毒(HBV)感染不同阶段及病程进展与转归预测中的作用。方法选取2016年2月至2017年3月间于本院就诊的HBV患者共268例。分析HBV-DNA载量低于2 000 IU/mL时,不同HBV-DNA水平组间和组内年龄、性别、乙型肝炎E抗原(HBeAg)和HBsAg定量结果等指标的作用和意义。结果 HBV-DNA载量测定结果发现,<20 IU/mL者135人;HBV-DNA载量<2 000 IU/mL患者共235例,其中HBeAg(-)占比75.32%(177/235);HBeAg(+)患者占比24.68%(58/235);HBV-DNA载量<20 IU/mL时,其组内HBeAg(+)和HBeAg(-)间年龄分布对比,P=0.001,HBV-DNA载量为20~199 IU/mL时,两组对比,P=0.002,HBV-DNA载量为200~1 999 IU/mL时,两组对比P=0.001,差异均有统计学意义(P<0.05);HBV-DNA载量<20 IU/mL与20~199 IU/mL间,<20 IU/mL与200~1 999 IU/mL间丙氨酸氨基转移酶(ALT)水平对比,P值分别为0.001和0.002,差异有统计学意义(P<0.05);HBV-DNA载量<20 IU/mL、20~199 IU/mL和200~1 999 IU/mL三组间HBsAg水平两两对比,差异均有统计学意义(P<0.05),三组各组内HBeAg(+)组和HBeAg(-)组间HBsAg水平对比,差异均有统计学意义(P<0.05)。结论 HBV-DNA载量测定联合HBsAg定量分析能够更好的预测HBV-DNA载量低于2 000 IU/mL的慢性乙肝患者的病情进展和转归。

Objective To analyze the effect of hepatitis B virus DNA（HBV-DNA）loading combined with hepatitis B surface antigen（HBsAg）quantitative analysis on the progression and prognosis of chronic hepatitis B virus（HBV）infection at different stages. Methods A total of 268 patients with chronic hepatitis B who were treated in our hospital from February 2016 to March 2017 were selected. When the HBV-DNA level was below 2 000 IU/mL,the indicating role and significant of different levels HBV-DNA for different age,sex,hepatitis Be antigen（HBeAg）level and HBsAg level was analyzed. Results The results of HBV-DNA loading showed that there were 135 patients in 20 IU/mL;There were 235 patients with HBV-DNA load less than 2 000 IU/mL,among them,HBeAg（-）accounted for 75.32%（177/235）,HBeAg（＋）accounted for 24.68%（58/235）. When HBV-DNA less than 20 IU/mL,or of 20-199 IU/mL,age distribution of HBeAg（＋）and HBeAg（-）of the two groups were significantly different（P=0.001、0.002）,and when the HBV-DNA load was 200-1 999 IU/mL,the difference was also significant（P=0.001）. The differences of alanine aminotransferase（ALT）levels of HBV-DNA load 〈20 IU/mL and 20-199 IU/mL,〈20 IU/mL and 200-1 999 IU/mL were significant（P=0.001 and 0.002,respectively）. The differences of HBsAg levels of HBV-DNA load 〈20 IU/mL,20-199 IU/mL and 200-1 999 IU/mL were significant（P〈0.05）. HBsAg levels in HBeAg（＋）group and HBeAg（-）group were significantly different among the 3 ranges of HBV-DNA load（P〈0.05）. Conclusion HBV-DNA load assay combined with HBsAg quantitative analysis can better predict the progression and outcome of patients with chronic hepatitis B with HBV-DNA load less than 2 000 IU/mL.