CAJ | 학술논문

目的：探讨慢性乙型肝炎病毒（HBV）感染者不同病期乙型肝炎五项指标（HBV-M）模式的分布及其与肝功能和HBV-DNA 载量的关系。方法采集456例慢性 HBV 感染者血清标本，定量检测 HBV-M、肝功能及 HBV-DNA 载量；根据病期不同将患者分为慢性乙型肝炎组（包括轻度、中度、重度亚组），肝硬化组（包括代偿亚组、失代偿亚组）和肝癌组。结果3组间HBsAg、HBeAg、HBcAb 阳性模式（135模式）和 HBsAg、HBeAb、HBcAb 阳性模式（145模式）所占比例比较，差异有统计学意义（P ＜0．05）。慢性乙型肝炎各亚组135模式的丙氨酸氨基转移酶（ALT）和天冬氨酸氨基转移酶（AST）水平高于另两种模式，差异有统计学意义（P ＜0．05）；肝硬化各亚组和肝癌组中，3种 HBV-M 模式的清蛋白（ALB）和总胆红素（TBIL）水平进行比较，差异有统计学意义（P ＜0．05）。各组135模式 HBV-DNA 载量均高于另两组，差异有统计学意义（P ＜0．05）。结论随着慢性乙型肝炎病情的进展，135模式的比例呈现下降趋势，145模式的比例呈上升趋势；在区分 HBV 慢性感染者病期的情况下，ALT、AST、ALB、TBIL 水平及 HBV-DNA 载量与 HBV-M 模式密切相关。
목적：탐토만성을형간염병독（HBV）감염자불동병기을형간염오항지표（HBV-M）모식적분포급기여간공능화HBV-DNA 재량적관계。방법채집456례만성 HBV 감염자혈청표본，정량검측 HBV-M、간공능급 HBV-DNA 재량；근거병기불동장환자분위만성을형간염조（포괄경도、중도、중도아조），간경화조（포괄대상아조、실대상아조）화간암조。결과3조간HBsAg、HBeAg、HBcAb 양성모식（135모식）화 HBsAg、HBeAb、HBcAb 양성모식（145모식）소점비례비교，차이유통계학의의（P ＜0．05）。만성을형간염각아조135모식적병안산안기전이매（ALT）화천동안산안기전이매（AST）수평고우령량충모식，차이유통계학의의（P ＜0．05）；간경화각아조화간암조중，3충 HBV-M 모식적청단백（ALB）화총담홍소（TBIL）수평진행비교，차이유통계학의의（P ＜0．05）。각조135모식 HBV-DNA 재량균고우령량조，차이유통계학의의（P ＜0．05）。결론수착만성을형간염병정적진전，135모식적비례정현하강추세，145모 식 적 비 례 정 상 승 추 세；재구분 HBV 만성감염자병기적정황하，ALT、AST、ALB、TBIL 수평급 HBV-DNA 재량여 HBV-M 모식밀절상관。
Objective To investigate the distribution of five indicators of hepatitis B(HBV-M)and its relationship with liver function parameters and HBV-DNA load in patients with chronic HBV infection in different stages.Methods The serum samples were collected from 456 patients infected with HBV.The HBV-M,liver functional parameters and HBV-DNA level were quantita-tively detected.According to the stages of disease,the patients were divided into 3 groups including chronic hepatitis B group(inclu-ding mild subgroup,moderate subgroup and severe subgroup),liver cirrhosis group(including compensatory subgroup,decompen-sated subgroup)and hepatocellular carcinoma goup.Results The ratio of HBsAg,HBeAg,HBcAb positive pattern(135 pattern) and HBsAg,HBeAb,HBcAb positive pattern(145 pattern)in the three groups were statistically different(P <0.05).In each chron-ic hepatitis B subgroup,both ALT and AST levels of 135 pattern were significantly higher than the other two patterns(P <0.05). In each liver cirrhosis subgroup and hepatocellular carcinoma group,there were statistically significant differences in ALB and TBIL levels between the three patterns(P <0.05 ).In each group,the HBV-DNA level of 135 positive pattern were significantly higher than the other two patterns(P <0.05).Conclusion With the advancement of chronic hepatitis B,there is a downtrend in the ratio of 135 pattern and increasing trend in the ratio of 145 pattern.If the stage of hepatitis B is discriminated,ALT,AST,ALB TBIL and HBV-DNA level were closely related to HBV-M pattern.