CAJ | 학술논문

目的了解HBV共价闭合环状DNA (cccDNA)与血清HBV DNA、HBsAg、ALT、患者年龄等临床指标的关系,探讨这些指标替代HBV cccDNA的价值. 方法 60例慢性HBV感染者在B型超声的引导下,采用1s快速切割组织法获取肝组织,用荧光定量PCR法检测肝组织HBVcccDNA和血清HBV DNA,用全自动化学发光仪(雅培I-2000)检测血清HBsAg,并检测其他临床指标如ALT、AST、Y谷氨酰转移酶、碱性磷酸酶、白蛋白、球蛋白、白细胞、血小板、凝血酶原国际标准化比值和人口学资料,并分析这些指标与肝组织HBV cccDNA的相关性.相关性分析用Spearman或Pearson方法. 结果肝组织中的HBV cccDNA与患者年龄、球蛋白、ALT和肝组织炎症分级显著负相关,≤30岁组HBV cccDNA水平显著高于＞30岁组,分别为(7.44±0.58) log10拷贝/ml和(5.66±1.35)log10拷贝/ml,两组间差异有统计学意义(t=7.157,P＜0.001),而与血清HBV DNA和血清HBsAg呈显著正相关(r值分别为0.916、0.727,P值均＜0.001),HBV cccDNA与血清HBVDNA、HBsAg比值的中位值分别为1.18和1.67.结论肝组织HBV cccDNA随着年龄增长而下降,高球蛋白、高ALT和肝组织炎症重者其肝组织HBV cccDNA越低,随着血清HBV DNA和HBsAg水平升高而升高;血清HBV DNA和HBsAg水平可在一定程度上反应肝组织的HBV cccDNA水平.
목적 료해HBV공개폐합배상DNA (cccDNA)여혈청HBV DNA、HBsAg、ALT、환자년령등림상지표적관계,탐토저사지표체대HBV cccDNA적개치. 방법 60례만성HBV감염자재B형초성적인도하,채용1s쾌속절할조직법획취간조직,용형광정량PCR법검측간조직HBVcccDNA화혈청HBV DNA,용전자동화학발광의(아배I-2000)검측혈청HBsAg,병검측기타림상지표여ALT、AST、Y곡안선전이매、감성린산매、백단백、구단백、백세포、혈소판、응혈매원국제표준화비치화인구학자료,병분석저사지표여간조직HBV cccDNA적상관성.상관성분석용Spearman혹Pearson방법. 결과 간조직중적HBV cccDNA여환자년령、구단백、ALT화간조직염증분급현저부상관,≤30세조HBV cccDNA수평현저고우＞30세조,분별위(7.44±0.58) log10고패/ml화(5.66±1.35)log10고패/ml,량조간차이유통계학의의(t=7.157,P＜0.001),이여혈청HBV DNA화혈청HBsAg정현저정상관(r치분별위0.916、0.727,P치균＜0.001),HBV cccDNA여혈청HBVDNA、HBsAg비치적중위치분별위1.18화1.67.결론 간조직HBV cccDNA수착년령증장이하강,고구단백、고ALT화간조직염증중자기간조직HBV cccDNA월저,수착혈청HBV DNA화HBsAg수평승고이승고;혈청HBV DNA화HBsAg수평가재일정정도상반응간조직적HBV cccDNA수평.
Objective To investigate the correlation between intrahepatic eovalently closed circular (ccc)DNA of hepatitis B virus (HBV) and pathogen-and patient-related parameters.Methods Ultrasound-guided liver biopsies were obtained from 60 patients with chronic HBV infection.Levels of intrahepatic HBV cccDNA and serum HBV DNA were measured by quantitative fluorescence PCR.Level of serum hepatitis B surface antigen (HBsAg) was measured by chemiluminescence immunoassay.Clinical parameters,such as alanine aminotransferase (ALT),aspartate aminotransferase (AST),gamma-glutamyl transferase (GGT),alkaline phosphatase (AKP),albumin,globulin (GLO),white blood cell,platelet,prothrombin-international normalized ratio,were measured by standard assay.Demographic information was recorded.The correlation between intrahepatic HBV cccDNA and pathogen-and patient-related parameters was assessed.Results Intrahepatic HBV cccDNA level was negatively correlated with age,GLO,ALT and grade of necroinflammation.Patients with age of 30 years or more showed significantly higher level of HBV cccDNA level than patients under 30 years-old (7.44±0.58 and 5.66±1.35; t =7.157,P ＜ 0.001).Intrahepatic HBV cccDNA level was positively correlated with serum HBV DNA level (r =0.916,P ＜ 0.001) and serum HBsAg level (r =0.727,P ＜ 0.001).The median ratio of HBV cccDNA to HBV DNA was 1.18,and of HBV cccDNA to HBsAg was 1.67.Conclusion Intrahepatic HBV cccDNA levels decrease with age,level of ALT,level of GLO and grade of liver necroinflammation,but increase with level of serum HBV DNA and level of serum HBsAg.To a certain extent,serum HBV DNA and serum HBsAg levels may be a sufficient marker of intrahepatic HBV cccDNA levels.