藏族HBsAg阳性者血清标志物组合模式与HBV-DNA及ALT的相关性分析

Analysis on correlation between serum marker combination mode and HBV-DNA, ALT in Tibetan people with HBsAg positive

目的:探讨藏族HBsAg阳性者血清标志物组合模式与乙肝病毒载量(HBV-DNA)以及丙氨酸氨基转移酶(ALT)之间的关系。方法:选取815例藏族HBsAg阳性者为研究对象,采用酶联免疫吸附法进行乙肝血清标志物(HBV-M)定性检测、实时荧光定量PCR-荧光探针法检测HBV-DNA、全自动生化分析仪测定ALT;Mann-Whitney U test用于两分组样本之间的比较,Kruskal-Wallis H分析多组非参数连续数据,两变量间的相关性采用Spearman等级相关分析,计数资料用卡方检验,P<0.05为差异有统计学意义。结果:①藏族HBsAg阳性者男性多于女性(1.3:1)且主要分布在11∼60岁,平均年龄(37.16±14.38)岁;②HBV-M组合模式共有7种,以小三阳(42.7%)和大三阳(38.5%)为主,且大三阳模式的HBV-DNA与ALT异常率均显著高于小三阳(P<0.001);③藏族HBsAg阳性者的HBV-DNA载量与ALT水平呈正相关(rs=0.244,P<0.001)、与年龄呈负相关(rs=-0.223,P<0.001);④HBsAg阳性者中不同性别间ALT有统计学意义(P<0.001),而HBVDNA载量间无统计学意义(P>0.05);⑤HBeAg(+)与(-)两组间HBV-DNA、ALT的差异均有统计学意义(P<0.001)。结论:本研究发现的7种HBV-M模式中主要为小三阳、大三阳,HBeAg阳性者的病毒复制水平和ALT异常率最高;HBV-DNA载量与不同的HBV-M模式、年龄以及ALT异常有关,与性别无关。

A total of 815 Tibetan with HBsAg positive selected as the research subject,the relationship between serum marker combination patterns and hepatitis B virus load(HBV-DNA)and alanine aminotransferase(ALT)were analyzed in Tibetan people with HBsAg positive.Enzyme-linked immunosorbent assay(ELISA)was applied to detect HBV-M qualitatively,real-time fluorescence quantitative PCR-fluorescence probe was used to detect HBV-DNA load,and automatic biochemical analyzer was used to determine ALT.Non-parametric analysis,Mann-Whitney U-test was used to compare two groups of samples,and Kruskal-Wallis H was used to analyze multiple groups of non-parametric continuous data.The Chi-square test was used on counting data and the correlation between the two variables was analyzed by Spearman rank correlation at P<0.05 statistically significant.The number of HBsAg positive in Tibetans was higher in males than that in females(1.3:1)with an average age of(37.16±14.38).There were seven combinations of hepatitis B serum markers(HBV-M),mainly HBsAg+,HBeAb+,HBcAb+(42.7%),HBsAg+,HBeAg+and HBcAb+(38.5%),and the positive rates of HBV-DNA and ALT in HBsAg+、HBeAg+and HBcAb+model were significantly higher than those in HBsAg+、HBeAb+and HBcAb+(P<0.001).HBV-DNA load was positively correlated with ALT(rs=0.244,P<0.001),and negatively correlated with age(rs=-0.223,P<0.001).ALT of different sexes in HBsAg positive patients was statistically significant(P<0.001),but there was no significant difference in HBV-DNA load(P>0.05).The difference in HBVDNA and ALT between HBeAg(+)and(-)groups was statistically significant(P<0.001).Among the seven HBV-M modes found in this study,the HBeAg-positive patients with major HBV-M and minor HBeAg-positive had the highest viral replication level and ALT abnormality rate;HBV-DNA load was related to different HBV-M modes,ages and ALT abnormalities,but not relation with gender.