高灵敏度血清病毒学指标检测技术在低病毒载量乙型肝炎人群中的应用价值

Application value of high sensitivity detection technology of serum virological indexes in patients with low viral load hepatitis B

目的探讨高灵敏度血清病毒学指标检测技术在低病毒载量乙型肝炎(HB)人群中的应用价值。方法选定本院2017年4月至2019年5月收诊的HB患者130例,采用常规国产试剂对其乙肝病毒脱氧核糖核酸(HBV DNA)进行检测,按照HBV DNA是否<500 IU/mL将其分为观察组(56例,<500 IU/mL)和对照组(74例,≥500 IU/mL)。再通过高灵敏度检测试剂对观察组的HBV DNA进行测定,以HBV DNA 20 IU/mL作为检测的下限,将其分为阳性组(30例,≥20 IU/mL)和阴性组(26例,<20 IU/mL)。比较各组间的间接胆红素(IBIL)、直接胆红素(DBIL)、总胆红素(TBIL)、谷草转氨酶(AST)、谷丙转氨酶(ALT)、总胆固醇(TG)、甘油三酯(TC)、癌胚抗原(CEA)、甲胎蛋白(AFP)水平,并分析HBV DNA病毒载量是否与ALT、AST存在相关性。结果观察组的IBIL、DBIL、TBIL、AST、ALT、TG、TC、CEA、AFP水平均低于对照组,差异具有统计学意义(P<0.05)。阳性组的IBIL、DBIL、TBIL、TG、TC、CEA、AFP与阴性组比较,差异不显著(P>0.05);阳性组的AST、ALT水平均高于阴性组,差异具有统计学意义(P<0.05)。Pearson相关性分析结果显示,ALT与HB患者的HBV DNA病毒载量存在正相关(r=0.471,P<0.05);而AST则与其无相关性(r=0.152,P>0.05)。结论高灵敏度检测试剂能够有效判断低病毒载量HB患者的肝功能水平,其中ALT还与HBV DNA病毒载量存在相关性,可反映患者的肝细胞损害程度,为后续治疗提供依据。

Objective To explore the application value of high sensitivity detection technology of serum virological indexes in patients with low viral load hepatitis B(HB).Methods A total of 130 patients with HB admitted in our hospital from April 2017 to May 2019 were selected,and routine domestic reagents was used to detect HBV DNA.According to whether HBV DNA was less than 500 IU/mL,the patients were divided into observation group(56 cases,<500 IU/mL)and control group(74 cases,≥500 IU/mL).Then the HBV DNA of the observation group was determined by high sensitivity detection reagent.Taking HBV DNA 20 IU/mL as the detection limit,the observation group was divided into positive group(30 cases,≥20 IU/mL)and negative group(26 cases,<20 IU/mL).The levels of indirect bilirubin(IBIL),direct bilirubin(DBIL),total bilirubin(TBIL),aspartate aminotransferase(AST),alanine aminotransferase(ALT),total cholesterol(TG),triglyceride(TC),carcinoembryonic antigen(CEA),alpha fetoprotein(AFP)were compared among the groups,and the correlation between HBV DNA viral load and ALT and AST were analyzed.Results The levels of IBIL,DBIL,TBIL,AST,ALT,TG,TC,CEA and AFP in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).There were no significant differences in the levels of IBIL,DBIL,TBIL,TG,TC,CEA and AFP between the positive group and the negative group(P>0.05);the levels of AST and ALT in the positive group were higher than those in the negative group,and the differences were statistically significant(P<0.05).Pearson correlation analysis result showed that there was a positive correlation between ALT and HBV DNA viral load in HB patients(r=0.471,P<0.05);but there was no correlation between AST and HBV DNA viral load(r=0.152,P>0.05).Conclusion High sensitivity detection reagents can effectively determine the level of liver function in patients with low viral load HB.ALT is also correlated with HBV DNA viral load,which can reflect the degree of liver cell damage and provide a basis for subsequent treatment in patients.