中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2011年
28期
20-23
,共4页
黎美祥%谢冬英%邓洪%刘琼%高志良
黎美祥%謝鼕英%鄧洪%劉瓊%高誌良
려미상%사동영%산홍%류경%고지량
肝功能衰竭,急性%肝炎,乙型,慢性%肝炎表面抗原,乙型
肝功能衰竭,急性%肝炎,乙型,慢性%肝炎錶麵抗原,乙型
간공능쇠갈,급성%간염,을형,만성%간염표면항원,을형
Liver failure,acute%Hepatitis B,chronic%Hepatitis B surface antigens
目的 探讨HBV相关慢加急性肝衰竭(ACLF)患者血清HBsAg水平与HBV DNA水平及病情严重程度的关系.方法 选取慢性乙型肝炎(CHB)患者119例(CHB组)和ACLF患者98例(ACLF组).采用罗氏电化学发光法检测血清HBsAg和HBeAg,荧光定量PCR法检测血清HBVDNA水平.分别比较两组不同HBeAg状态患者的HBsAg和HBV DNA水平差异以及HBsAg和HBV DNA水平的相关性.结果 ACLF组和CHB组患者血清HBeAg阴性患者分别占68.4％(67/98)和42.9％(51/119),差异有统计学意义(P＜0.01).ACLF组血清HBV DNA水平与CHB组比较差异无统计学意义(P＞0.05),两组血清HBeAg阳性患者HBV DNA均高于同组血清HBeAg阴性患者(P＜0.05).ACLF组血清HBsAg水平在血清HBeAg阳性和阴性患者间比较差异无统计学意义(P＞0.05),但均高于CHB组血清HBeAg阳性患者(P＜0.05).血清HBeAg阳性患者血清HBsAg与丙氨酸氨基转移酶、天冬氨酸氨基转移酶具有相关性(P＜0.05),血清HBeAg阴性患者血清HBsAg与血清HBV DNA水平及生化指标无显著相关性(P＞0.05).不同HBV DNA水平ACLF患者中不同HBsAg水平患者的比例比较差异无统计学意义(P＞0.05).结论 HBV相关ACLF患者血清HBsAg水平与HBV DNA水平及病情的严重程度无直接平行关系.
目的 探討HBV相關慢加急性肝衰竭(ACLF)患者血清HBsAg水平與HBV DNA水平及病情嚴重程度的關繫.方法 選取慢性乙型肝炎(CHB)患者119例(CHB組)和ACLF患者98例(ACLF組).採用囉氏電化學髮光法檢測血清HBsAg和HBeAg,熒光定量PCR法檢測血清HBVDNA水平.分彆比較兩組不同HBeAg狀態患者的HBsAg和HBV DNA水平差異以及HBsAg和HBV DNA水平的相關性.結果 ACLF組和CHB組患者血清HBeAg陰性患者分彆佔68.4％(67/98)和42.9％(51/119),差異有統計學意義(P＜0.01).ACLF組血清HBV DNA水平與CHB組比較差異無統計學意義(P＞0.05),兩組血清HBeAg暘性患者HBV DNA均高于同組血清HBeAg陰性患者(P＜0.05).ACLF組血清HBsAg水平在血清HBeAg暘性和陰性患者間比較差異無統計學意義(P＞0.05),但均高于CHB組血清HBeAg暘性患者(P＜0.05).血清HBeAg暘性患者血清HBsAg與丙氨痠氨基轉移酶、天鼕氨痠氨基轉移酶具有相關性(P＜0.05),血清HBeAg陰性患者血清HBsAg與血清HBV DNA水平及生化指標無顯著相關性(P＞0.05).不同HBV DNA水平ACLF患者中不同HBsAg水平患者的比例比較差異無統計學意義(P＞0.05).結論 HBV相關ACLF患者血清HBsAg水平與HBV DNA水平及病情的嚴重程度無直接平行關繫.
목적 탐토HBV상관만가급성간쇠갈(ACLF)환자혈청HBsAg수평여HBV DNA수평급병정엄중정도적관계.방법 선취만성을형간염(CHB)환자119례(CHB조)화ACLF환자98례(ACLF조).채용라씨전화학발광법검측혈청HBsAg화HBeAg,형광정량PCR법검측혈청HBVDNA수평.분별비교량조불동HBeAg상태환자적HBsAg화HBV DNA수평차이이급HBsAg화HBV DNA수평적상관성.결과 ACLF조화CHB조환자혈청HBeAg음성환자분별점68.4％(67/98)화42.9％(51/119),차이유통계학의의(P＜0.01).ACLF조혈청HBV DNA수평여CHB조비교차이무통계학의의(P＞0.05),량조혈청HBeAg양성환자HBV DNA균고우동조혈청HBeAg음성환자(P＜0.05).ACLF조혈청HBsAg수평재혈청HBeAg양성화음성환자간비교차이무통계학의의(P＞0.05),단균고우CHB조혈청HBeAg양성환자(P＜0.05).혈청HBeAg양성환자혈청HBsAg여병안산안기전이매、천동안산안기전이매구유상관성(P＜0.05),혈청HBeAg음성환자혈청HBsAg여혈청HBV DNA수평급생화지표무현저상관성(P＞0.05).불동HBV DNA수평ACLF환자중불동HBsAg수평환자적비례비교차이무통계학의의(P＞0.05).결론 HBV상관ACLF환자혈청HBsAg수평여HBV DNA수평급병정적엄중정도무직접평행관계.
Objective To analyze the relationship between HBsAg level and HBV DNA level as well as illness severity in patients with HBV-related acute-on-chronic liver failure (ACLF).Methods One hundred and nineteen patients with chronic hepatitis B (CHB group) and 98 patients with ACLF(ACLF group) were enrolled.HBsAg and HBeAg were assayed with Roche electrochemical luminescence method.HBV DNA was quantified using a real-time polymerase chain reaction (PCR) assay.HBsAg and HBV DNA levels were compared between two groups and between HBeAg-positive and HBeAg-negative patients in ACLF group respectively,also the correlationbetween HBsAg and HBV DNA was studied.Results The proportions of HBeAg-negative patients were 68.4％(67/98) and 42.9％(51/119) in ACLF group and CHB group respectively,and there was significant difference between two groups (P ＜0.01).There was no significant difference in HBV DNA between two groups (P ＞ 0.05).HBV DNA in HBeAg-positive patients was higher than that in HBeAg-negative patients in two groups(P ＜ 0.05).There was no significant difference in HBsAg between HBeAg-positive patients and HBeAg-negative patients in ACLF group (P ＞ 0.05 ),but they were higher than that in HBeAg-positive patients in CHB group (P＜ 0.05).HBsAg was correlated to ALT,AST in HBeAg-positive patients (P ＜ 0.05).No significant correlation was found among HBsAg and HBV DNA as well as biochemical changes (P＞ 0.05).There was no significant difference in the ratio of different HBsAg levels among the patients of different HBV DNA in ACLF group (P＞ 0.05).Conclusion The level of HBsAg does not directly correlate with serum HBV DNA level,and has no directly correlation with the severity of the disease in patients with HBV-related ACLF.
