中华传染病杂志
中華傳染病雜誌
중화전염병잡지
CHINESE JOURNAL OF INFECTIOUS DISEASES
2012年
8期
468-471
,共4页
曾达武%董菁%朱月永%陈靖%郑琦%陈丽红%刘豫瑞%江家骥
曾達武%董菁%硃月永%陳靖%鄭琦%陳麗紅%劉豫瑞%江傢驥
증체무%동정%주월영%진정%정기%진려홍%류예서%강가기
肝炎,乙型,慢性%炎症%肝硬化%肝炎e抗原,乙型
肝炎,乙型,慢性%炎癥%肝硬化%肝炎e抗原,乙型
간염,을형,만성%염증%간경화%간염e항원,을형
Hepatitis B,chronic%Inflammation%Liver cirrhosis%Hepatitis B e antigen
目的 探讨免疫清除(IC)期慢性乙型肝炎(CHB)患者血清HBeAg水平与肝脏炎症活动度分级(G)、纤维化分期(S)的关系.方法 连续收集2007年3月至2010年6月福建医科大学附属第一医院肝病中心确诊为IC期的CHB患者,同步行肝组织病理学检查及血清HBeAg和HBVDNA检测.Spearman等级相关分析法判断HBeAg水平与肝脏病理学分级间的相关性,受试者工作曲线(ROC)法判断HBeAg水平对肝脏G分级及S分期的预测价值.结果 共249例IC期CHB患者纳入本研究,G1～G4患者血清HBeAg水平分别为(2.93±2.85)、(2.96±2.74)、(2.69±2.67)和(2.30±2.41) lg s/co,S1～S4患者血清HBeAg水平分别为(2.99±2.74)、(2.89±2.73)、(2.58±2.55)和(2.32±2.44)lg s/co,提示4组患者G分级及S分期间HBeAg水平差异均有统计学意义(x2值分别为47.13和74.12,均P＜0.01).Spearman等级相关分析提示血清HBeAg水平与G分级、S分期呈负相关(r值分别为-0.418和-0.532,均P＜0.01).判断G≥3和G≥4,S≥3和S≥4患者的受试者工作曲线下面积(AUC)分别为0.74和0.73,0.80和0.77; HBeAg最佳截点分别为2.95、2.64、2.99和2.82 lg s/co.结论 在IC期CHB中,肝组织学G分级及S分期与HBeAg水平呈负相关.结合HBeAg水平,有助于肝脏病理学变化程度的判断.
目的 探討免疫清除(IC)期慢性乙型肝炎(CHB)患者血清HBeAg水平與肝髒炎癥活動度分級(G)、纖維化分期(S)的關繫.方法 連續收集2007年3月至2010年6月福建醫科大學附屬第一醫院肝病中心確診為IC期的CHB患者,同步行肝組織病理學檢查及血清HBeAg和HBVDNA檢測.Spearman等級相關分析法判斷HBeAg水平與肝髒病理學分級間的相關性,受試者工作麯線(ROC)法判斷HBeAg水平對肝髒G分級及S分期的預測價值.結果 共249例IC期CHB患者納入本研究,G1～G4患者血清HBeAg水平分彆為(2.93±2.85)、(2.96±2.74)、(2.69±2.67)和(2.30±2.41) lg s/co,S1～S4患者血清HBeAg水平分彆為(2.99±2.74)、(2.89±2.73)、(2.58±2.55)和(2.32±2.44)lg s/co,提示4組患者G分級及S分期間HBeAg水平差異均有統計學意義(x2值分彆為47.13和74.12,均P＜0.01).Spearman等級相關分析提示血清HBeAg水平與G分級、S分期呈負相關(r值分彆為-0.418和-0.532,均P＜0.01).判斷G≥3和G≥4,S≥3和S≥4患者的受試者工作麯線下麵積(AUC)分彆為0.74和0.73,0.80和0.77; HBeAg最佳截點分彆為2.95、2.64、2.99和2.82 lg s/co.結論 在IC期CHB中,肝組織學G分級及S分期與HBeAg水平呈負相關.結閤HBeAg水平,有助于肝髒病理學變化程度的判斷.
목적 탐토면역청제(IC)기만성을형간염(CHB)환자혈청HBeAg수평여간장염증활동도분급(G)、섬유화분기(S)적관계.방법 련속수집2007년3월지2010년6월복건의과대학부속제일의원간병중심학진위IC기적CHB환자,동보행간조직병이학검사급혈청HBeAg화HBVDNA검측.Spearman등급상관분석법판단HBeAg수평여간장병이학분급간적상관성,수시자공작곡선(ROC)법판단HBeAg수평대간장G분급급S분기적예측개치.결과 공249례IC기CHB환자납입본연구,G1～G4환자혈청HBeAg수평분별위(2.93±2.85)、(2.96±2.74)、(2.69±2.67)화(2.30±2.41) lg s/co,S1～S4환자혈청HBeAg수평분별위(2.99±2.74)、(2.89±2.73)、(2.58±2.55)화(2.32±2.44)lg s/co,제시4조환자G분급급S분기간HBeAg수평차이균유통계학의의(x2치분별위47.13화74.12,균P＜0.01).Spearman등급상관분석제시혈청HBeAg수평여G분급、S분기정부상관(r치분별위-0.418화-0.532,균P＜0.01).판단G≥3화G≥4,S≥3화S≥4환자적수시자공작곡선하면적(AUC)분별위0.74화0.73,0.80화0.77; HBeAg최가절점분별위2.95、2.64、2.99화2.82 lg s/co.결론 재IC기CHB중,간조직학G분급급S분기여HBeAg수평정부상관.결합HBeAg수평,유조우간장병이학변화정도적판단.
Objective To investigate the relationship between serum HBeAg level and inflammation grade (G)/fibrosis stage (S) in the liver tissues of chronic hepatitis B (CHB) patients in the immune clearance phase (IC). Methods Both liver biopsy samples and serum samples were consecutively collected from CHB patients in Liver Center,First Affiliated Hospital,Fujian Medical University during March 2007 to June 2010.Electro-chemiluminescence and fluorogenic quantitative polymerase chain reaction (PCR) methods were used to determine HBeAg titer and hepatitis B virus (HBV) DNA level,respectively.The relationships between HBeAg titer and liver pathological stages were analyzed using Spearman rank correlation analysis.Receive operating characteristic (ROC) curve was used to evaluate the diagnostic value of HBeAg for liver pathological stages.Results Totally 249 patients with CHB were enrolled into this study.The serum HBeAg absorbances in patients with liver inflammation G1 to G4 were (2.93±2.85),(2.96±2.74),(2.69±2.67) and (2.30±2.41) lg s/co,respectively,while those in patients with liver fibrosis S1 to S4 were (2.99±2.74),(2.89±2.73),(2.58±2.55) and (2.32±2.44) lg s/co,respectively,which indicated that serum HBeAg titers were significant different in patients with different grading and staging of liver tissues (x2 =47.13,P＜0.01; x2 =74.12,P＜0.01).Spearman rank correlation analysis showed that serum HBeAg titer was negatively correlated with inflammation grades and fibrosis stages of liver tissues (r=-0.418 and-0.532,respectively; both P＜0.01).ROC curve analysis revealed that the areas under the curve (AUC) were 0.74 (G≥≥3) and 0.73 (G≥4),and the HBeAg (s/co) cut-off values were 2.95 and 2.64 lg s/co,respectively.Similarly,ROC curve analysis revealed that the AUC were 0.80 (S≥3) and 0.77 S≥4),and the HBeAg cut-off values were 2.99 and 2.82 lg s/co,respectively.Conclusions The serum HBeAg titer is negatively correlated with the inflammation grades and fibrosis stages m liver tissues of CHB patients in IC phase.The level of HBeAg may be used as an adjunctive noninvasive marker to reflect the inflammation and fibrosis status in the liver.
