HBeAg阴性慢性乙型肝炎患者血清25-羟基维生素D_3的检测及临床意义

Detection and Clinical Significance of Serum 25-hydroxyvitamin D_3 in Patients with HBeAg-negative Chronic Hepatitis B

目的探究HBeAg阴性慢性乙型肝炎患者血清25-羟基维生素D3的水平变化及临床意义。方法选取2015年3月～2018年5月81例HBeAg阴性且非肝硬化的慢性乙型肝炎患者作为观察组,依据血清谷丙转氨酶(ALT)水平分为观察组A 41例(ALT处于正常水平且HBV DNA水平<2000 IU/ml,持续时间高于6个月)和观察组B 40例(ALT处于升高水平且HBV DNA水平≥2000 IU/ml,持续时间高于6个月)。同时选取同期健康体检人群40例作为对照组。分别检测三组血清25-羟基维生素D_3的浓度。结果观察组血清25-羟基维生素D_3低于健康人群,统计学意义显著(P<0.001),三组间比较,统计学意义显著(P<0.001)。观察组患者血清25-羟基维生素D3与年龄、BMI、ALT、AST、Hb、WBC、PLT及AFP均无明显相关性(P>0.05)。而与HBV DNA含量间存在显著负相关(r=-3.981,P<0.05)。结论 HBeAg阴性慢性乙型肝炎患者血清25-羟基维生素D_3存在异常,并与乙肝病毒复制相关,可能参与机体和乙肝病毒的免疫反应过程。

Objective To investigate the changes and clinical significance of serum 25-hydroxyvitamin D3 levels in patients with HBeAg-negative chronic hepatitis B.Methods From March 2015 to May 2018,81 patients with HBeAg-negative and non-cirrhotic chronic hepatitis B were enrolled as observation group.According to serum alanine aminotransferase （ALT）levels,41 patients in observation group A （ALT was at normal level and HBV DNA level was 〈2000 IU/ml,duration was higher than 6 months）and 40 patients in group observation B （ALT was at elevated level and HBV DNA level was /〉2000 IU/ml for more than 6 months）.At the same time,40 healthy people in the same period were selected as the control group.The concentrations of serum 25-hydroxyvitamin D3 were measured separately.Results The serum 25-hydroxyvitamin D3 in the observation group was lower than that in the healthy group,and the statistical significance was significant （P〈0.001）.The comparison between the three groups was statistically significant （P〈0.001）.There was no significant correlation between serum 25-hydroxyvitamin D3 and age,BMI,ALT,AST,Hb,WBC, PLT and AFP in the observation group （P〉0.05）.There was a significant negative correlation with HBV DNA content （r=-3.981,P〈0.05）.Conclusion The serum of 25-hydroxyvitamin D3 in patients with HBeAg-negative chronic hepatitis B is abnormal and related to hepatitis B virus replication, which may be involved in the immune response process between the body and hepatitis B virus.