中华实验和临床病毒学杂志
中華實驗和臨床病毒學雜誌
중화실험화림상병독학잡지
CHINESE JOURNAL OF EXPERIMENTAL AND CLINICAL VIROLOGY
2012年
1期
51-53
,共3页
赖菁%李学俊%张绍全%徐启桓%朱建芸%柯伟民
賴菁%李學俊%張紹全%徐啟桓%硃建蕓%柯偉民
뢰정%리학준%장소전%서계환%주건예%가위민
肝炎e抗原,乙型%肝功能衰竭%病毒载量%终末期肝病模型
肝炎e抗原,乙型%肝功能衰竭%病毒載量%終末期肝病模型
간염e항원,을형%간공능쇠갈%병독재량%종말기간병모형
Hepatitis Be antigens%Liver failure%Viral load%Model for end-stage liver disease
目的 探讨乙型肝炎慢加急性肝衰竭(ACLF)患者临终前HBeAg状态与HBV DNA载量和MELD(终末期肝病模型)分值变化的关系及其临床意义.方法 分析120例乙型肝炎ACLF患者临终前0～14d,15 ～ 28 d和29 ～ 90 d时段血清HBeAg状态、HBV DNA载量和MELD值.结果 51例HBeAg阳性患者上述三时段的HBV DNA载量依次是(5.25±1.99),(5.45±1.47)和(6.06±1.77) log10拷贝/ml,MELD值分别为(30.33±5.25),(26.36±6.43)和(20.13±6.47).而69例HBeAg阴性患者上述三时段的HBV DNA载量顺次是(5.14±1.84),(5.49±1.75)和(4.62±1.65) log10拷贝/ml,MELD值按序为(32.38±9.95),(28.17±6.82)和(26.19±5.56).同一时间段比较,HBeAg阳性与HBeAg阴性患者间HBV DNA载量和MELD值均仅在临终前29～90 d的差异有统计学意义(P＜0.05).三个时段间比较,不论HBeAg阳/阴性,HBV DNA载量的差异均无统计学意义(P＞0.05),而MELD值随着病情进展呈持续升高且差异均有统计学意义(P＜0.05).结论 为启动乙型肝炎ACLF,HBeAg阳性患者的HBV DNA水平高于HBeAg阴性者.一旦ACLF启动,无论HBeAg状态如何,持续高HBV DNA载量可促进病情向终末期发展.
目的 探討乙型肝炎慢加急性肝衰竭(ACLF)患者臨終前HBeAg狀態與HBV DNA載量和MELD(終末期肝病模型)分值變化的關繫及其臨床意義.方法 分析120例乙型肝炎ACLF患者臨終前0～14d,15 ～ 28 d和29 ～ 90 d時段血清HBeAg狀態、HBV DNA載量和MELD值.結果 51例HBeAg暘性患者上述三時段的HBV DNA載量依次是(5.25±1.99),(5.45±1.47)和(6.06±1.77) log10拷貝/ml,MELD值分彆為(30.33±5.25),(26.36±6.43)和(20.13±6.47).而69例HBeAg陰性患者上述三時段的HBV DNA載量順次是(5.14±1.84),(5.49±1.75)和(4.62±1.65) log10拷貝/ml,MELD值按序為(32.38±9.95),(28.17±6.82)和(26.19±5.56).同一時間段比較,HBeAg暘性與HBeAg陰性患者間HBV DNA載量和MELD值均僅在臨終前29～90 d的差異有統計學意義(P＜0.05).三箇時段間比較,不論HBeAg暘/陰性,HBV DNA載量的差異均無統計學意義(P＞0.05),而MELD值隨著病情進展呈持續升高且差異均有統計學意義(P＜0.05).結論 為啟動乙型肝炎ACLF,HBeAg暘性患者的HBV DNA水平高于HBeAg陰性者.一旦ACLF啟動,無論HBeAg狀態如何,持續高HBV DNA載量可促進病情嚮終末期髮展.
목적 탐토을형간염만가급성간쇠갈(ACLF)환자림종전HBeAg상태여HBV DNA재량화MELD(종말기간병모형)분치변화적관계급기림상의의.방법 분석120례을형간염ACLF환자림종전0～14d,15 ～ 28 d화29 ～ 90 d시단혈청HBeAg상태、HBV DNA재량화MELD치.결과 51례HBeAg양성환자상술삼시단적HBV DNA재량의차시(5.25±1.99),(5.45±1.47)화(6.06±1.77) log10고패/ml,MELD치분별위(30.33±5.25),(26.36±6.43)화(20.13±6.47).이69례HBeAg음성환자상술삼시단적HBV DNA재량순차시(5.14±1.84),(5.49±1.75)화(4.62±1.65) log10고패/ml,MELD치안서위(32.38±9.95),(28.17±6.82)화(26.19±5.56).동일시간단비교,HBeAg양성여HBeAg음성환자간HBV DNA재량화MELD치균부재림종전29～90 d적차이유통계학의의(P＜0.05).삼개시단간비교,불론HBeAg양/음성,HBV DNA재량적차이균무통계학의의(P＞0.05),이MELD치수착병정진전정지속승고차차이균유통계학의의(P＜0.05).결론 위계동을형간염ACLF,HBeAg양성환자적HBV DNA수평고우HBeAg음성자.일단ACLF계동,무론HBeAg상태여하,지속고HBV DNA재량가촉진병정향종말기발전.
Objective To investigate the relationship and clinical significances of HBeAg status with serum HBV DNA loads,model for end-stage liver disease (MELD) scores in patients with acute-on-chronic hepatitis B liver failure during terminal phase.Methods 120 fatal patients were enrolled.At three phases of 0 -14 d,15 -28 d and 29 -90 d before death,they were detected serum HBeAg,HBV DNA loads order meanwhile MELD scores were calculated.Results In 51 patients with HBeAg positive,HBV DNA levels were (5.25 ± 1.99),(5.45 ± 1.47) and (6.06 ± 1.77) log10 copies/ml while MELD scores were (30.33 ± 5.25 ),(26.36 ± 6.43 ) and (20.13 ± 6.47) respectively.In 69 patients with HBeAg negative,HBV DNA loads were (5.14 ± 1.84),(5.49 ± 1.75 ) and (4.62 ± 1.65 ) log10 copies/ml while MELD scores were 32.38 ± 9.95,28.17 ±6.82 and 26.19 ± 5.56 in sequence.Compared with the same phase between HBeAg-positive group and HBeAg-negative group,significant differences in both HBV DNA loads and MELD scores were found only at the phase of 29 - 90 d (P ＜ 0.05 ).In multiple comparisons among three phases,regardless of the HBeAg status,there wasn't significant difference for HBV DNA loads (P ＞0.05).But increasing MELD scores are associated with the disease exacerbation and significant differences were found (P ＜ 0.05).Conclusions To initiate acute-on-chronic hepatitis B liver failure,serum HBV DNA loads of HBeAg-positive patients are higher than that of HBeAg-negative ones.Once ACLF has been initiated,sustained high HBV DNA loads may promote the disease worsened and be fatal regardless of the HBeAg status.
