乙型肝炎患者乙肝五项指标与肝硬度相关性分析

The correlation between five tests of hepatitis B and liver hardness in patients with hepatitis B virus infectious diseases

目的分析乙型肝炎患者血清乙肝五项指标与肝硬度的相关性。方法选择2018年7月-2019年7月张家港市第一人民医院收治的182例慢性HBV感染患者血清标本,采用化学发光免疫分析法检测患者乙肝五项:表面抗原(HBsAg)、表面抗体(HBsAb)、e抗原(HBeAg)、e抗体(HBeAb)、核心抗体(HBcAb)。HBsAg(+)HBeAg(+)HBcAb(+)模式为HBeAg(+)组86例,HBsAg(+)HBeAb(+)HBcAb(+)模式为HBeAg(-)组86例,采用肝脏瞬时弹性成像技术检测肝脏硬度值(LSM),采用化学发光法检测血清肝功能指标:丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、白蛋白(ALB)、总胆红素(TBIL)及肝纤维化相关指标:透明质酸酶(HA)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(CⅣ)、层粘连蛋白(LN)水平,采用Pearson法分析LSM与肝功能指标及肝纤维化指标的相关性。结果HBeAg(+)组患者HBV-DNA阳性感染率(39.53%vs.20.93%)、LSM、肝功能指标(ALT、AST、ALB、TBIL)水平、肝纤维化指标(HA、PCⅢ、CⅣ、LN)水平均显著高于HBeAg(-)组(χ^(2)=6.202,P=0.013;t=26.384、30.772、6.527、2.978、14.955、35.119、27.351、25.763、19.712,P均<0.05),其中ALB、CⅣ、LN均在正常范围内。HBeAg(+)组患者LSM水平与ALT、AST、ALB、TBIL、HA、PCⅢ、CⅣ、LN水平均呈正相关(r=0.510、0.477、0.408、0.542、0.531、0.541、0.540、0.606,P均<0.05)。结论血清乙肝五项与HBV传染病患者LSM、肝功能及肝纤维化密切相关,联合检测可能对乙肝诊疗有一定指导意义。

Objective To analyze the correlation between serum hepatitis B five tests and liver hardness in patients with hepatitis B virus(HBV)infectious diseases.Methods 182 serum samples of patients with chronic HBV infection admitted to our hospital from July 2018 to July 2019 were selected.Chemiluminescent immunoassay was used to detect the hepatitis B surface antigens(HBsAg),surface antibodies(HBsAb),e antigens(HBeAg),e antibodies(HBeAb)and core antibodies(HBcAb).HBsAg(+)HBeAg(+)HBcAb(+)mode in HBeAg(+)group had 86 cases;HBsAg(+)HBeAb(+)HBcAb(+)mode in HBeAg(-)group had 86 cases.Liver stiffness(LSM)was measured by transient elastography;serum liver function indexes and the levels of liver fibrosis related indicators were measured by chemiluminescence.Pearson method was used to analyze the correlations between LSM and liver function indexes and liver fibrosis indexes.Results HBV-DNA positive infection rate(39.53%vs.20.93%),LSM,liver function indexes(ALT,AST,ALB,TBIL),liver fibrosis indexes(HA,PCⅢ,CⅣ,LN)in HBeAg(+)group were significantly higher than those in HBeAg(-)group(χ^(2)=6.202,P=0.013;t=26.384,30.772,6.527,2.978,14.955,35.119,27.351,25.763,19.712,all P<0.05),and ALB,CⅣand LN were all in the normal range.LSM level in HBeAg(+)group was positively correlated with ALT,AST,ALB,TBIL,HA,PCⅢ,CⅣand LN levels(r=0.510,0.477,0.408,0.542,0.531,0.541,0.540,0.606,all P<0.05).Conclusions Serum hepatitis B five indexes were closely related to LSM,liver function and liver fibrosis in patients with hepatitis B virus infectious diseases.The combined detection might have some guiding significance for the diagnosis and treatment of hepatitis B.