CAJ | 학술논문

目的：探讨丙型肝炎病毒（HCV）感染患者 HCV抗体（HCV-Ab）、HCV核糖核酸（HCV-RNA）水平的变化及其在诊断治疗中的意义。方法随机收集临床诊断为HCV感染患者血清，采用化学发光微粒子免疫检测法测定HCV-Ab ，PCR-荧光探针法检测HCV-RNA ，同时检测丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）。根据ALT、AST 水平以及HCV-RNA水平分别分为两组，分析比较两组间各指标的变化。同时收集37例临床抗病毒治疗患者的血清，分析治疗前后各指标的变化。结果肝功异常组HCV-Ab、RNA载量对数值水平均高于肝功正常组（P＜0．05）。HCV-RNA阳性组HCV-Ab、ALT、AST水平均高于HCV-RNA阴性组（P＜0．05）。HCV-Ab、RNA载量对数值诊断丙型肝炎的ROC曲线下面积分别为0．990、0．838。连续观察病例治疗后ALT、AST、RNA载量对数值水平均较治疗前下降（P＜0．05）；而 HCV-Ab治疗前后差异无统计学意义（P＞0．05）。结论 HCV-Ab对于丙型肝炎的诊断效能优于RNA载量对数值。ALT、AST 及 HCV-RNA检测在丙型肝炎治疗监测过程中有重要临床意义。
목적：탐토병형간염병독（HCV）감염환자 HCV항체（HCV-Ab）、HCV핵당핵산（HCV-RNA）수평적변화급기재진단치료중적의의。방법수궤수집림상진단위HCV감염환자혈청，채용화학발광미입자면역검측법측정HCV-Ab ，PCR-형광탐침법검측HCV-RNA ，동시검측병안산안기전이매（ALT）、천문동안산안기전이매（AST）。근거ALT、AST 수평이급HCV-RNA수평분별분위량조，분석비교량조간각지표적변화。동시수집37례림상항병독치료환자적혈청，분석치료전후각지표적변화。결과간공이상조HCV-Ab、RNA재량대수치수평균고우간공정상조（P＜0．05）。HCV-RNA양성조HCV-Ab、ALT、AST수평균고우HCV-RNA음성조（P＜0．05）。HCV-Ab、RNA재량대수치진단병형간염적ROC곡선하면적분별위0．990、0．838。련속관찰병례치료후ALT、AST、RNA재량대수치수평균교치료전하강（P＜0．05）；이 HCV-Ab치료전후차이무통계학의의（P＞0．05）。결론 HCV-Ab대우병형간염적진단효능우우RNA재량대수치。ALT、AST 급 HCV-RNA검측재병형간염치료감측과정중유중요림상의의。
Objective To explore changes of anti-HCV antibody and HCV-RNA in patients with HCV infection and its clinical significance in diagnosis and treatment of hepatitis C .Methods Serum samples from patients with HCV infection were collected . HCV antibodies were analyzed with a chemiluminescence micro-particle immunoassay method ,while a PCR-fluorescent probe meth-od was used to detect HCV-RNA .Concentrations of ALT and AST were also determined .Based on the concentrations of ALT , AST and HCV-RNA ,samples were divided into two groups respectively and the changes of different indicators were analyzed and compared .Meanwhile samples from 37 HCV-infected patients were collected continuously .Different indicators after treatment were compared with those before treatment .Results HCV-Ab and logarithm values of RNA load in the group with abnormal concentra-tions of ALT and AST were significantly higher than those in the normal group (P<0 .05) .HCV-Ab ,ALT and AST concentrations in HCV-RNA positive group were significantly higher than those in HCV-RNA negtive group(P<0 .05) .The areas under receiver operating characteristic curve of HCV-Ab and logarithm values of RNA load were 0 .990 and 0 .838 respectively .Concentrations of ALT ,AST and logarithm values of RNA load after treatment were significantly lower than those before treatment (P<0 .05) while there was no significance between HCV-Ab level after treatment and that before treatment (P>0 .05) .Conclusion The diagnostic performance of HCV-Ab is better than that of logarithm values of RNA load .Determination of ALT ,AST and HCV-RNA is of clinical importance in monitoring the effect of hepatitis C treatment .