失代偿期病毒性肝炎患者病毒载量分析及其与凝血功能的关系探讨

Analysis of Viral Load and its Relationship with Coagulation Function in Patients with Decompensated Viral Hepatitis

目的探讨失代偿期病毒性肝炎患者病毒载量分析及其与凝血功能的关系。方法选取2020年1月—2022年12月吉水县疾病预防控制中心收治的失代偿期病毒性肝炎患者68例为病毒性肝炎组,健康体检者26名为健康组。根据患者HBV-DNA载量将患者分为A组(HBV-DNA载量≤5×103 copy/mL,n=11),B组(HBV-DNA载量5×103~5×105 copy/mL,n=22),C组(HBV-DNA载量5×105~5×107 copy/mL,n=19),D组(HBV-DNA载量≥5×107 copy/mL,n=16)。检测纳入对象的HBV-DNA载量、凝血功能[凝血酶原时间(PT),活化部分凝血酶时间(APTT),凝血酶时间(TT)]和肝功能[丙氨酸氨基转移酶(ALT)、总胆红素(TB)、白蛋白(ALB)]水平,对HBV-DNA载量与凝血功能(PT、APTT、TT)水平进行相关性分析。结果病毒性肝炎组凝血功能(PT、APTT、TT)、肝功能(ALT、TB)高于健康组(P<0.05),ALB低于健康组(P<0.05)。A组PT、APTT、ALT、TB水平低于B组、C组、D组,ALB水平高于D组,差异具有统计学意义(P<0.05)。B组APTT、ALT、TB水平低于C组、D组,PT水平低于C组,差异具有统计学意义(P<0.05)。C组ALT、TB水平低于D组,PT水平高于D组,差异具有统计学意义(P<0.05)。相关性分析结果显示,HBV-DNA载量与凝血功能(PT、TT)水平无相关性(r=0.134,0.031;P=0.815,0.953),与APTT呈正相关(r=0.421,P<0.001)。结论失代偿期病毒性肝炎患者病毒载量与APTT存在正相关性,患者凝血功能能够有效判断失代偿期病毒性肝炎患者病情进展。

Objective To explore viral load and its relationship with coagulation function in patients with decompensated viral hepatitis.Methods 68 patients with decompensated viral hepatitis and 26 healthy controls in Disease Prevention and Control Center of Jishui County were enrolled as viral hepatitis group and healthy group between January 2020 and December 2022.According to HBV-DNA load,patients were divided into group A(≤5×103 copy/mL,n=11),group B(5×103-5×105 copy/mL,n=22),group C(5×105-5×107 copy/mL,n=19)and group D(≥5×107 copy/mL,n=16).HBV-DNA load,coagulation function[prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT)]and liver function[alanine aminotransferase(ALT),total bilirubin(TB),albumin(ALB)]were detected.The correlation between HBV-DNA load and coagulation function indexes was analyzed.Results The coagulation function indexes(PT,APTT,TT)and liver function indexes(ALT,TB)in viral hepatitis group were higher than those in healthy group(P<0.05),while ALB was lower than that in healthy group(P<0.05).PT,APTT,ALT and TB in group A were lower than those in groups B,C and D,and ALB was higher than that in group D(P<0.05).APTT,ALT and TB in group B were lower than those in groups C and D,and PT was shorter than that in group C(P<0.05).ALT and TB in group C were lower than those in group D,and PT was longer than that in group D(P<0.05).The results of correlation analysis showed that HBV-DNA load was not correlated with coagulation function indexes(PT,TT)(r=0.134,0.031,P=0.815,0.953),but which was positively correlated with APTT(r=0.421,P<0.001).Conclusion There is a positive correlation between viral load and APTT in patients with decompensated viral hepatitis.The coagulation function can effectively determine disease progression in patients with decompensated viral hepatitis.