“小三阳”肝炎患者HBsAg和HBV-DNA水平与肝脏损伤程度的相关性研究

Study on correlation between HBsAg and HBV-DNA levels and liver damage degree in patients with "small three positive" hepatitis

目的探讨"小三阳"肝炎患者乙型肝炎病毒(HBV)血清标志物HBsAg水平和HBV脱氧核糖核酸(HBV-DNA)载量与其肝功能指标的关系。方法选取2018年2月至2019年2月该院收治的住院"小三阳"肝炎患者422例作为病例组,另选取同期健康体检者248例作为对照组,比较两组前清蛋白(PAB)、α-L-岩藻糖苷酶(AFU)、腺苷脱氨酶(ADA)和单胺氧化酶(MAO)(后简称4项肝功能指标)表达水平;将病例组患者依据血清标志物HBsAg不同水平分为4组,比较各组4项肝功能指标的表达水平;将病例组患者依据HBVDNA不同载量分为5组,比较各组4项肝功能指标的表达水平。结果病例组的PAB水平显著低于对照组,AFU、ADA和MAO水平均显著高于对照组,差异均有统计学意义(P<0.05);病例组不同HBsAg水平区间患者的PAB水平比较,随着HBsAg水平的升高,PAB水平逐渐降低,差异均有统计学意义(P<0.05),但患者的AFU、ADA和MAO水平比较,差异均无统计学意义(P>0.05);病例组不同HBV-DNA载量区间患者的PAB、AFU、ADA和MAO水平比较,随着HBV-DNA载量的增加,PAB水平逐渐降低,AFU、ADA和MAO水平均逐渐升高,差异均有统计学意义(P<0.05)。结论 "小三阳"患者HBsAg水平和HBV-DNA载量增加时,会造成肝脏不同程度的损伤,其中以HBV-DNA载量的变化引起4项肝功能指标改变更为敏感。

Objective To investigate the relationship between serum marker HBsAg level of hepatitis B virus(HBV)and HBV-DNA load with liver function indexes in the inpatients with "small three positive" hepatitis,so as to provide scientific basis and reasonable guidance for clinical evaluation of liver injury degree in patients with HBV infection.Methods A total of 422 inpatients with small three positive hepatitis in this hospital were selected as the case group,and contemporaneous 248 cases of healthy physical examination were selected as the control group.The expression levels of prealbumin(PAB),α-L-fucosidase(AFU),adenosine deaminase(ADA)and monoamine oxidase(MAO)were compared between the two groups.The case group was divided into 4 groups according to different levels of serum marker HBsAg.The expression levels of four liver function indexes were compared among the 4 groups.The case group was divided into 5 groups according to different loads of HBV-DNA.Then the expression levels of 4 liver function indexes were compared among 5 groups.Results The PAB level in the small three positive hepatitis group was significantly lower than that in the control goup,while the AFU,ADA and MAO levels were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).In the comparison of PAB level in the case group among different HAsAg level intervals,the PAB level was gradually decreased with the HBsAg level increase,and the difference was statistically significant(P<0.05),but the comparison of AFU,ADA and MAO levels showed no statistically significant difference(P >0.05).In the comparison of PAB,AFU,ADA and MAO in the case group among different HBV-DNA loads intervals,the PAB level was gradually decreased with the HBV-DNA load increase,while the AFU,ADA and MOA levels were gradually increased,and the differences were statistically significant(P<0.05).Conclusion The increase of HBsAg level and HBV-DNA load in the patients with "small three positive" will cause the liver damage to different degrees,in which the changes of HBV-DNA load causing the change of four liver function indicators are more sensitive.