HBsAg及HBV DNA定量检测在慢性乙型肝炎患者不同病程阶段中的应用价值

Application value of HBsAg and HBV DNA quantitative detection in different stages of chronic hepatitis B

目的研究慢性乙型肝炎(简称乙肝)患者病程进展中HBsAg及HBVDNA定量水平变化及其相关性,比较其在慢性乙肝不同病程阶段的水平。方法收集2015年1月至2016年12月于该院就诊的302例慢性HBV感染患者血清,分为轻、中及重型慢性乙肝组。采用化学发光法定量检测HBsAg水平,采用实时荧光定量聚合酶链反应(PCR)检测血清HBVDNA水平。多组间比较采用非参数Kruskal-WallisH检验,进一步两两比较采用Mann-WhitneyU检验,采用Spearman检验进行数据间的相关性分析。结果轻、中、重型慢性乙肝组HBsAg定量水平中位数分别为2583.96、6998.34、3669.91U/mL,3组比较差异有统计学意义(Z=15.50,P<0.05);轻型慢性乙肝组与中型慢性乙肝组HBsAg定量水平比较,差异有统计学意义(Z=-3.89,P<0.05);中型慢性乙肝组与重型慢性乙肝组HBsAg定量水平比较,差异有统计学意义(Z=-2.32,P<0.05);轻型慢性乙肝组与重型慢性乙肝组HBsAg定量水平比较,差异无有统计学意义(Z=-1.22,P>0.05)。轻、中、重型慢性乙肝组HBVDNA定量水平中位数分别为246500、2840000、894000logcopy/mL,3组比较差异有统计学意义(Z=9.33,P<0.05);轻型慢性乙肝组与中型慢性乙肝组HBVDNA定量水平比较,差异有统计学意义(Z=-2.96,P<0.05);其他两两比较,HBVDNA定量水平差异无统计学意义(P>0.05)。HBsAg与HBVDNA在轻型慢性乙肝组、中型慢性乙肝组、重型慢性乙肝组患者中均呈正相关(r=0.68、0.60、0.66,P<0.05)。结论HBsAg及HBVDNA在慢性HBV感染患者不同病程阶段均呈正相关,可作为预测慢性乙肝病程进展的血清学标志物。

Objective To study the quantitative level change and correlation of HBsAg and HBV-DNA levels in patients with chronic hepatitis B,and to compare their levels in different stages of chronic hepatitis B. Methods The serum samples of 302 patients with chronic HBV infection were collected from January 2015 to December 2016 in Shunde Hospital of Southern Medical University,and they were divided into three groups:mild,moderate and severe chronic hepatitis B groups.The HBsAg level was quantitatively detected by chemiluminescence enzyme immunoassay,and the real-time fluorescent quantitative PCR technique was applied to detect the serum HBV-DNA capacity.Non-parametric Kruskal-Wallis H test was used for comparison among groups,and Mann-Whitney U test was used for further pairwise comparison.Data correlation analysis was performed by Spearman test. Results The median HBsAg values in patients with mild,moderate,and severe chronic hepatitis B were 2 583.96,6 998.34,and 3 669.91 U/mL,respectively,and the differences were statistically significant ( Z =15.50, P <0.05).There was significant difference in HBsAg quantitative level between mild chronic hepatitis B group and moderate chronic hepatitis B group ( Z =-3.89, P <0.05).There was significant difference in HBsAg quantitative level between moderate chronic hepatitis B group and severe chronic hepatitis B group ( Z =-2.32, P <0.05).There was no significant difference in the quantitative level of HBsAg between mild chronic hepatitis B group and severe chronic hepatitis B group ( Z =-1.22, P >0.05).The median HBV DNA quantification levels in mild,moderate and severe chronic hepatitis B groups were 246 500,2 840 000 and 894 000 log copy/mL,respectively,and the differences were statistically significant among the three groups ( Z =9.33, P <0.05).There was a significant difference in HBV DNA quantitative level between mild chronic hepatitis B group and moderate chronic hepatitis B group ( Z =-2.96, P <0.05),but there was no significant difference between the other two groups ( P >0.05).HBsAg and HBV DNA were positively correlated in mild chronic hepatitis B group,moderate chronic hepatitis B group,severe chronic hepatitis B group and patients ( r =0.68,0.60,0.66, P <0.05). Conclusion HBsAg and HBV-DNA are positively correlated in different stages of chronic HBV infection,and can be used as a serological marker for predicting the progression of chronic hepatitis B.