南方医科大学学报
南方醫科大學學報
남방의과대학학보
JOURNAL OF SOUTHERN MEDICAL UNIVERSITY
2015年
5期
682-686
,共5页
余雪平%郭如意%柯邵鹏%黄清流%林成祖%林志鹏%陈素梅%李菊兰%杨鹏雅%苏智军
餘雪平%郭如意%柯邵鵬%黃清流%林成祖%林誌鵬%陳素梅%李菊蘭%楊鵬雅%囌智軍
여설평%곽여의%가소붕%황청류%림성조%림지붕%진소매%리국란%양붕아%소지군
HBsAg%HBVDNA%肝炎%乙型%慢性%肝硬化
HBsAg%HBVDNA%肝炎%乙型%慢性%肝硬化
HBsAg%HBVDNA%간염%을형%만성%간경화
HBsAg%HBV DNA%hepatitis B,chronic%liver cirrhosis
目的：探讨慢性乙型肝炎（CHB）、乙型肝炎肝硬化（HBV-LC）患者HBsAg定量和HBVDNA定量的变化及两者的相关性。方法采集46例CHB轻中度患者（CHB-LM组），24例CHB重度患者（CHB-S组）和28例HBV-LC患者入院时及51例患者经核苷（酸）类似物（NA）抗病毒治疗4.08±3.06月时的血清标本；采用化学发光法定量检测HBsAg水平，荧光PCR定量检测HBVDNA载量。多组比较采用Kruskal-Wallis，两组间比较采用Mann-Whitney U检验，治疗前后比较采用Wilcoxon检测，相关性分析采用Spearman检验。结果 HBsAg和HBVDNA定量在CHB-LM组、CHB-S组和HBV-LC组中逐渐下降（χ2=12.537和8.381，P=0.002和0.015）；CHB-LM组和CHB-S组HBsAg和HBV DNA定量值均高于HBV-LC组（P<0.05）；CHB-LM和CHB-S两组之间差异均无统计学意义（Z=-0.649和0.032，P>0.05）。HBeAg阳性患者HBsAg和HBVDNA定量在CHB-LM组、CHB-S组和HBV-LC组中呈下降趋势（χ2=6.146，P=0.046和1.009，P>0.05）；CHB-LM组HBsAg定量高于HBV-LC组（Z=-2.247，P=0.025）。HBeAg阴性患者HBsAg和HBVDNA定量在CHB-LM组、CHB-S组和HBV-LC组中逐渐下降（χ2=7.196和14.658，P<0.05）；CHB-LM组和CHB-S组HBsAg和HBV DNA定量均高于HBV-LC组（P<0.01）。HBsAg与HBVDNA定量水平在CHB-LM组（r=0.389，P=0.009）、HBV-LC组（r=0.431，P=0.022）中均呈正相关性；而在CHB-S组中无相关性（r=0.348，P=0.104）。与NA抗病毒治疗前相比，51例患者治疗后HBsAg水平略有下降（Z=-1.050，P=0.294），而HBVDNA水平明显下降（Z=-5.415，P<0.001）；治疗后HBsAg定量与HBVDNA定量无统计学相关性（r=0.241，P=0.111）；且两者治疗前后的差值也无统计学相关性（r=0.257，P=0.085）。结论 HBsAg和HBVDNA定量在CHB-LM、CHB-S和HBV-LC患者中逐渐降低，按照HBeAg阳性和阴性分组后，这种趋势依然存在；HBsAg和HBVDNA之间呈正相关，但并非绝对平行。
目的：探討慢性乙型肝炎（CHB）、乙型肝炎肝硬化（HBV-LC）患者HBsAg定量和HBVDNA定量的變化及兩者的相關性。方法採集46例CHB輕中度患者（CHB-LM組），24例CHB重度患者（CHB-S組）和28例HBV-LC患者入院時及51例患者經覈苷（痠）類似物（NA）抗病毒治療4.08±3.06月時的血清標本；採用化學髮光法定量檢測HBsAg水平，熒光PCR定量檢測HBVDNA載量。多組比較採用Kruskal-Wallis，兩組間比較採用Mann-Whitney U檢驗，治療前後比較採用Wilcoxon檢測，相關性分析採用Spearman檢驗。結果 HBsAg和HBVDNA定量在CHB-LM組、CHB-S組和HBV-LC組中逐漸下降（χ2=12.537和8.381，P=0.002和0.015）；CHB-LM組和CHB-S組HBsAg和HBV DNA定量值均高于HBV-LC組（P<0.05）；CHB-LM和CHB-S兩組之間差異均無統計學意義（Z=-0.649和0.032，P>0.05）。HBeAg暘性患者HBsAg和HBVDNA定量在CHB-LM組、CHB-S組和HBV-LC組中呈下降趨勢（χ2=6.146，P=0.046和1.009，P>0.05）；CHB-LM組HBsAg定量高于HBV-LC組（Z=-2.247，P=0.025）。HBeAg陰性患者HBsAg和HBVDNA定量在CHB-LM組、CHB-S組和HBV-LC組中逐漸下降（χ2=7.196和14.658，P<0.05）；CHB-LM組和CHB-S組HBsAg和HBV DNA定量均高于HBV-LC組（P<0.01）。HBsAg與HBVDNA定量水平在CHB-LM組（r=0.389，P=0.009）、HBV-LC組（r=0.431，P=0.022）中均呈正相關性；而在CHB-S組中無相關性（r=0.348，P=0.104）。與NA抗病毒治療前相比，51例患者治療後HBsAg水平略有下降（Z=-1.050，P=0.294），而HBVDNA水平明顯下降（Z=-5.415，P<0.001）；治療後HBsAg定量與HBVDNA定量無統計學相關性（r=0.241，P=0.111）；且兩者治療前後的差值也無統計學相關性（r=0.257，P=0.085）。結論 HBsAg和HBVDNA定量在CHB-LM、CHB-S和HBV-LC患者中逐漸降低，按照HBeAg暘性和陰性分組後，這種趨勢依然存在；HBsAg和HBVDNA之間呈正相關，但併非絕對平行。
목적：탐토만성을형간염（CHB）、을형간염간경화（HBV-LC）환자HBsAg정량화HBVDNA정량적변화급량자적상관성。방법채집46례CHB경중도환자（CHB-LM조），24례CHB중도환자（CHB-S조）화28례HBV-LC환자입원시급51례환자경핵감（산）유사물（NA）항병독치료4.08±3.06월시적혈청표본；채용화학발광법정량검측HBsAg수평，형광PCR정량검측HBVDNA재량。다조비교채용Kruskal-Wallis，량조간비교채용Mann-Whitney U검험，치료전후비교채용Wilcoxon검측，상관성분석채용Spearman검험。결과 HBsAg화HBVDNA정량재CHB-LM조、CHB-S조화HBV-LC조중축점하강（χ2=12.537화8.381，P=0.002화0.015）；CHB-LM조화CHB-S조HBsAg화HBV DNA정량치균고우HBV-LC조（P<0.05）；CHB-LM화CHB-S량조지간차이균무통계학의의（Z=-0.649화0.032，P>0.05）。HBeAg양성환자HBsAg화HBVDNA정량재CHB-LM조、CHB-S조화HBV-LC조중정하강추세（χ2=6.146，P=0.046화1.009，P>0.05）；CHB-LM조HBsAg정량고우HBV-LC조（Z=-2.247，P=0.025）。HBeAg음성환자HBsAg화HBVDNA정량재CHB-LM조、CHB-S조화HBV-LC조중축점하강（χ2=7.196화14.658，P<0.05）；CHB-LM조화CHB-S조HBsAg화HBV DNA정량균고우HBV-LC조（P<0.01）。HBsAg여HBVDNA정량수평재CHB-LM조（r=0.389，P=0.009）、HBV-LC조（r=0.431，P=0.022）중균정정상관성；이재CHB-S조중무상관성（r=0.348，P=0.104）。여NA항병독치료전상비，51례환자치료후HBsAg수평략유하강（Z=-1.050，P=0.294），이HBVDNA수평명현하강（Z=-5.415，P<0.001）；치료후HBsAg정량여HBVDNA정량무통계학상관성（r=0.241，P=0.111）；차량자치료전후적차치야무통계학상관성（r=0.257，P=0.085）。결론 HBsAg화HBVDNA정량재CHB-LM、CHB-S화HBV-LC환자중축점강저，안조HBeAg양성화음성분조후，저충추세의연존재；HBsAg화HBVDNA지간정정상관，단병비절대평행。
Objective To explore the changes in HBsAg titer and HBV DNA load and their correlation in patients with chronic hepatitis B (CHB) and HBV-related liver cirrhosis (HBV-LC). Methods Forty-six patients with mild to moderate CHB (CHB-LM), 24 patients with severe CHB (CHB-S), and 28 patients with HBV-LC at admission, and 51 patients with HBV-LC at 4.08± 3.06 months during antiviral treatment were tested for serum HBsAg titer and HBV DNA load using Abbott chemiluminescence and fluorescence quantitative PCR, respectively. Results The serum HBsAg titer and HBV DNA load gradually decreased with increased disease severity (from CHB-LM, CHB-S to HBV-LC;χ2=12.537 and 8.381, respectively, P<0.05). HBsAg titer and HBV DNA load were significantly higher in CHB-LM and CHB-S groups than in HBV-LC group (P<0.05), but comparable between CHB-LM and CHB-S groups (Z=-0.649 and 0.032, respectively, P>0.05). Among HBeAg-positive patients, HBsAg titer and HBV DNA load tended to decrease with increased disease severity (from CHB-LM, CHB-S to HBV-LC;χ2=6.146, P=0.046 andχ2=1.017, P>0.05;respectively), and CHB-LM group had significantly higher HBsAg titer than HBV-LC group (Z=-2.247, P=0.025). Among the HBeAg-negative patients, serum HBsAg and HBV DNA load gradually declined with the disease severity (χ2=8.660 and 13.581, respectively, P<0.05), and were obviously higher in CHB-LM and CHB-S groups than in HBV-LC group (P<0.05). Positive correlations were found between serum HBsAg and HBV DNA levels in CHB-LM (r=0.389, P=0.009) and HBV-LC groups (r=0.431, P=0.022), but not in CHB-S group (r=0.348, P=0.104). After antiviral therapy, the serum HBsAg titer was slightly decreased (Z=-1.050, P=0.294) while HBV DNA load markedly reduced (Z=-5.415, P<0.001), showing no correlation between them (r=0.241, P=0.111) or between the measurements before and after treatment (r=0.257, P=0.085). Conclusion Serum HBsAg titer and HBV DNA load decreases progressively from CHB-LM to CHB-S and HBV-LC in both HBeAg- positive and-negative patients. The serum HBsAg titer is positively correlated with HBV DNA load, but their levels are not consistently parallel.
