丙型肝炎抗体阳性患者HCV RNA与肝功能指标联合检测的意义

Significance of combined detection of HCV RNA and liver function indexes in HCV antibody positive patients

目的探讨丙型肝炎抗体阳性患者HCVRNA水平与肝功能主要指标的关系。方法选取235名丙型肝炎抗体阳性患者,使用实时荧光定量聚合酶链式反应(qPCR)检测HCV RNA水平,按HCV RNA检测结果<500IU/mL、500~107IU/mL和>107IU/mL分别划分为阴性组、低中病毒水平组、高病毒水平组。同时检测谷丙转氨酶(ALT)、谷草转氨酶(AST)、γ-谷氨酰基转移酶(GGT)、碱性磷酸酶(ALP)、总蛋白(TP)、白蛋白(ALB)、总胆红素(TBil)、直接胆红素(DBil)这8项肝功能指标。结果HCVRNA阳性率为71.06%(167/235),不同HCV病毒水平组之间的年龄和性别分布差异无统计学意义(P>0.05)。8项肝功能指标的异常率在7.23%~48.51%,其中不同HCV病毒水平组间的ALT、AST、GGT指标的异常率差异有统计学意义(P<0.05),且ALT和AST异常率随病毒水平逐渐升高,GGT异常率在有病毒感染组明显高于阴性组。不同HCV病毒水平组间,ALT、AST、GGT、ALB水平间差异有统计学意义(P<0.05)。HCVRNA水平与ALT、AST、GGT水平正相关(r=0.505、0.407、0.284,P<0.05)。结论丙型肝炎抗体阳性患者进行HCVRNA和肝功能的检测,有助于准确诊断丙型肝炎的感染、监测病毒活动以及评估肝脏的损害,对丙型肝炎的治疗具有十分重要的意义。

Objective To explore the relationship between HCV RNA levels and major liver func.tion indexes in HCV antibody positive patients.Methods 235 HCV antibody positive patients was enrolled.The HCV RNA level was tested by real time PCR.According to HCV RNA test results,<500 IU/mL,500.107 IU/mL and>107 IU/mL were divided into negative group,low virus level group and high virus level group respectively.8 major liver function indexes including ALT,AST,GGT,ALP,TP,ALB,TBil and DBil were monitored by fully automatic biochemical analyzer.Results HCV RNA positive rate was 71.06%(167/235).No significant difference was found in age and gender between different HCV virus levels groups(P>0.05).The abnormal rate of eight hepatic functional indexes was 7.23%.48.51%,while the abnormal rates of ALT,AST and GGT in different HCV virus levels groups were statistically significant(P<0.05).The abnormal rate of ALT and AST increased with the virus level,and the abnormal rate of GGT in virus infected group was significantly higher than in the negative group(P<0.05).There were significant differences in ALT,AST,GGT and ALB levels among different HCV virus levels(P<0.05).HCV RNA levels were positively correlated with ALT,AST,and GGT levels(r=0.505,0.407,0.284,P<0.05).Conclusion The detection of HCV RNA and liver function in patients with hepatitis C antibodypositive is helpful for the accurate diagnosis of hepatitis C infection,monitoring of viral activity and assessment of liver damage,and is of great significance for the treatment of hepatitis C.