慢性丙型肝炎患者血清丙型肝炎病毒载量与肝纤维化的相关性研究

Correlation between serum hepatitis C virus RNA titers and liver fibrosis in chronic Hepatitis C virus patients

目的研究慢性丙型肝炎患者血清丙型肝炎病毒(HCV)载量与肝纤维化的相关性。方法选取大连市第六人民医院2015年4~12月诊治的162例均无其他肝脏及重大疾病的慢性HCV患者。利用血清肝纤维化4项指标胶原Ⅳ(C-Ⅳ)、层粘连蛋白(LN)、Ⅲ型氨基末端前肽胶原蛋白(PⅢNP)和透明质酸(HA)及FibroScan瞬时弹性检测指标来探讨HCV核糖核酸(RNA)载量与肝纤维化的相关性。为了进一步研究HCV RNA病毒载量与肝纤维化的相关性,根据HCV RNA病毒载量结果将慢性HCV患者分为3组:lg(HCV RNA)≤5组,5<lg(HCV RNA)≤7组和lg(HCV RNA)>7组。162例患者全部收集到肝纤维化4项指标数据,其中仅有54例患者进行了瞬时弹性检测。HCV RNA病毒载量结果由仪器配套软件自动计算得到,用以10为底的对数形式表示。结果162例慢性HCV患者在不同病毒载量组别间,肝纤维化4项指标比较,差异均无统计学意义(P>0.05)。54例慢性HCV患者在不同病毒载量组别间Fibroscan比较,差异无统计学意义(P>0.05)。瞬时弹性检测值与C-Ⅳ、LN、PⅢNP及HA均呈正相关(r=0.530、0.340、0.289、0.438,P=0.000、0.007、0.023、0.000),HCV RNA病毒载量与肝纤维化4项指标及瞬时弹性检测值无关(P>0.05)。结论慢性HCV患者血清中HCV RNA病毒载量与C-Ⅳ、LN、PⅢNP、HA及瞬时弹性检测值均不相关,即血清中HCV RNA病毒载量可能不能反映肝脏纤维化程度。

Objective To investigate the relationship between serum hepatitis C virus(HCV)and liver fibrosis in patients with chronic HCV infection.Methods A total of 162 chronic HCV patients without other liver or major diseases admitted to the Dalian Sixth People′s Hospital from April to December 2015 were selected.The association between HCV ribonucleic acid(RNA)titers and liver fibrosis was studied by using serum collagenⅣ(C-Ⅳ),laminin(LN),Type-Ⅲpro-collagen(PⅢNP),hyaluronic acid(HA)and FibroScan transient elasticity.In order to further assess the correlation between HCV RNA titers and liver fibrosis,chronic HCV patients were divided into three groups according to the results of lg-transformed HCV RNA titers:lg(HCV RNA)≤5 group,5<lg(HCV RNA)≤7 group and lg(HCV RNA)>7 group.Four serum indices of liver fibrosis were collected from 162 patients,of which only 54 patients were tested for FibroScan transient elasticity.The serum HCV RNA titers were automatically calculated by the instrument software and used for the 10-base logarithmic representation.Results Among 162 patients with chronic HCV,there were no statistically significant differences in hepatic fibrosis among different viral load groups(P>0.05).There was no statistically significant difference in Fibroscan among 54 patients with chronic HCV in different viral load groups(P>0.05).FibroScan transient elasticity was correlated with C-Ⅳ,LN,PⅢNP and HA(r=0.530,0.340,0.289,0.438,P=0.000,0.007,0.023,0.000).The HCV RNA titers were not correlated with four serum indices of liver fibrosis(P>0.05).Conclusion Serum HCV RNA titers in patients with chronic HCV are not correlated with C-Ⅳ,LN,PⅢNP,HA and FibroScan transient elasticity,serum HCV RNA viral titers can not reflect the degree of liver fibrosis.