CAJ | 학술논문

目的观察HBV和HCV重叠感染的临床与病理,探讨HBV和HCV相互作用的特点.方法收集226例慢性肝病患者的血清学指标,实时荧光定量PCR法测定HBV DNA和HCVRNA,ELISA检测HBV血清标志物、抗-HCV抗体.行肝穿刺活组织病理检查、免疫组织化学HBsAg、HBcAg和原位杂交HBV DNA、HCV RNA检测.计数资料比较采用X2检验或Fisher确切率检验.结果 HBV和HCV重叠感染的重度慢性肝炎患者比例为62.50%,高于HBV或HCV单独感染者的27.05%和30.56%(X2=14.70,P＜0.01).HBV感染组的血ALT、AST、TBil、DBil和Alb高于HBV和HCV重叠感染组和HCV感染组,差异均有统计学意义(X2=8.52,P＜0.05).重叠感染组和HBV感染组的血HBsAg与肝内HBsAg一致率比较,差异均有统计学意义(X2=15.60,P＜0.01).HBV和HCV重叠感染组血清HBV DNA阳性率为12.5%,低于HBV单独感染组的87.7%(X2=17.66,P＜0.01);而HBV和HCV重叠感染组HCV RNA阳性率为75.0%,低于HCV单独感染组的80.6%,差异无统计学意义(P＞0.05).结论 HBV和HCV重叠感染导致的肝损伤更明显.
목적 관찰HBV화HCV중첩감염적림상여병리,탐토HBV화HCV상호작용적특점.방법 수집226례만성간병환자적혈청학지표,실시형광정량PCR법측정HBV DNA화HCVRNA,ELISA검측HBV혈청표지물、항-HCV항체.행간천자활조직병리검사、면역조직화학HBsAg、HBcAg화원위잡교HBV DNA、HCV RNA검측.계수자료비교채용X2검험혹Fisher학절솔검험.결과 HBV화HCV중첩감염적중도만성간염환자비례위62.50%,고우HBV혹HCV단독감염자적27.05%화30.56%(X2=14.70,P＜0.01).HBV감염조적혈ALT、AST、TBil、DBil화Alb고우HBV화HCV중첩감염조화HCV감염조,차이균유통계학의의(X2=8.52,P＜0.05).중첩감염조화HBV감염조적혈HBsAg여간내HBsAg일치솔비교,차이균유통계학의의(X2=15.60,P＜0.01).HBV화HCV중첩감염조혈청HBV DNA양성솔위12.5%,저우HBV단독감염조적87.7%(X2=17.66,P＜0.01);이HBV화HCV중첩감염조HCV RNA양성솔위75.0%,저우HCV단독감염조적80.6%,차이무통계학의의(P＞0.05).결론 HBV화HCV중첩감염도치적간손상경명현.
Objective To investigate the clinical and pathological features of patients co-infected with hepatitis B virus(HBV)and hepatitis C virus(HCV)and to study the underlying interaction between HBV and HCV in these patients.Methods The liver biopsy and sera samples of 226 patients with chronic hepatitis were collected.Real-time fluorescent quantitative polymerase chain reaction were used tO measure HBV DNA and HCV RNA,respectively.Enzyme-linked immunosorbent assay (ELISA)was utilized to detect HBV serological marker and anti-HCV antibody.Liver biopsy examination was performed through needle aspiration.HBsAg and HBcAg in liver tissue were detected by immunohistochemistry,while HBV DNA and HCV RNA were detected by in situ hybridization.Results Sixty two point five percent patients co-infected with HBV and HCV suffered from severe hepatitis,while the rates of those infected with HBV or HCV alone were 27.1%and 30.6%,respectively(X2=14.70,P＜0.01).The serum alanine aminotransferase,aspartate aminotransferase, total bilirubin.direct bilirubin and albumin levels of patients infected with HBV alone were higher than those of patients co-infected with HBV and HCV or those infected with HCV alone,which showed statistically significant difference(X2=8.52.P＜0.05).The HBsAg titers in serum samples and in liver tissue samples were inconsistent in both co-infected patients and HCV mono infected patients (X2=15.60,P＜0.01).The HBV DNA positive rate of co-infected patients was 12.5%,which was lower than that of patients infected with HBV alone(87.7%,X2=17.66,P＜0.01).Meanwhile,the HCV RNA positive rate of patients co-infected with HBV and HCV was 75.0%,which was lower than that of patients infected with HCV alone(80.6%).However,the difference was not statistically significant(P＞0.05).Conclusion Co-infection with HBV and HCV may induce severer liver injury than HBV infection or HCV infection alone.