CAJ | 학술논문

目的：探讨和评价血清乙型肝炎核心相关抗原（HBcrAg）预测慢性乙型肝炎（CHB）肝组织炎症活动度和纤维化程度的效能。方法 CHB 患者211例，其中 HBeAg 阳性和阴性患者分别为125例和86例。血清 HBcrAg 采用化学发光酶免疫法检测。数据处理和统计分析采用 SPSS 16．0软件。结果 HBeAg 阳性患者，血清 HBcrAg 与肝组织病理学分级和分期均呈显著负相关（rs ＝－0．305，P ＝0．001和 rs ＝－0．370，P ＝0．000），在不同病理学分级和分期之间的差异均有统计学意义（rs ＝16．756，P ＝0．000和 rs ＝25．003，P ＝0．000）。HBeAg 阴性患者，血清 HBcrAg 与病理学分级和分期均呈显著正相关（rs ＝0．476，P ＝0．000和 rs ＝0．556，P ＝0．000），在不同病理学分级和分期之间的差异均有统计学意义（rs ＝22．529，P ＝0．000和 rs ＝26．416，P ＝0．000）。HBeAg 阳性患者，血清 HBcrAg 预测病理学分级≥G3和分期≥S3的 ROC曲线下面积分别为0．722和0．739（P ＝0．000和 P ＝0．000）；以血清 HBcrAg≤4．81×104 kU／mL 和≤8．13×104 kU／mL为标准，其预测病理学分级≥G3和分期≥S3的灵敏度、特异度、准确度分别为0．706、0．714、0．712和0．821、0．698、0．736。HBeAg 阴性患者，血清 HBcrAg 预测病理学分级≥G2和分期≥S2的 ROC 曲线下面积分别为0．807和0．799（P ＝0．000和 P ＝0．000）；以血清 HBcrAg≥40．18 kU／mL 和≥10．64 kU／mL 为标准，其预测病理学分级≥G2和分期≥S2的灵敏度、特异度、准确度分别为0．821、0．724、0．756和0．775、0．696、0．733。结论血清 HBcrAg 能有效地预测 HBeAg 阳性患者的肝组织严重炎症活动度和严重纤维化程度以及 HBeAg 阴性患者的肝组织显著炎症活动度和显著纤维化程度。
목적：탐토화평개혈청을형간염핵심상관항원（HBcrAg）예측만성을형간염（CHB）간조직염증활동도화섬유화정도적효능。방법 CHB 환자211례，기중 HBeAg 양성화음성환자분별위125례화86례。혈청 HBcrAg 채용화학발광매면역법검측。수거처리화통계분석채용 SPSS 16．0연건。결과 HBeAg 양성환자，혈청 HBcrAg 여간조직병이학분급화분기균정현저부상관（rs ＝－0．305，P ＝0．001화 rs ＝－0．370，P ＝0．000），재불동병이학분급화분기지간적차이균유통계학의의（rs ＝16．756，P ＝0．000화 rs ＝25．003，P ＝0．000）。HBeAg 음성환자，혈청 HBcrAg 여병이학분급화분기균정현저정상관（rs ＝0．476，P ＝0．000화 rs ＝0．556，P ＝0．000），재불동병이학분급화분기지간적차이균유통계학의의（rs ＝22．529，P ＝0．000화 rs ＝26．416，P ＝0．000）。HBeAg 양성환자，혈청 HBcrAg 예측병이학분급≥G3화분기≥S3적 ROC곡선하면적분별위0．722화0．739（P ＝0．000화 P ＝0．000）；이혈청 HBcrAg≤4．81×104 kU／mL 화≤8．13×104 kU／mL위표준，기예측병이학분급≥G3화분기≥S3적령민도、특이도、준학도분별위0．706、0．714、0．712화0．821、0．698、0．736。HBeAg 음성환자，혈청 HBcrAg 예측병이학분급≥G2화분기≥S2적 ROC 곡선하면적분별위0．807화0．799（P ＝0．000화 P ＝0．000）；이혈청 HBcrAg≥40．18 kU／mL 화≥10．64 kU／mL 위표준，기예측병이학분급≥G2화분기≥S2적령민도、특이도、준학도분별위0．821、0．724、0．756화0．775、0．696、0．733。결론혈청 HBcrAg 능유효지예측 HBeAg 양성환자적간조직엄중염증활동도화엄중섬유화정도이급 HBeAg 음성환자적간조직현저염증활동도화현저섬유화정도。
Objective To appraise the efficacy of serum hepatitis B core-related antigen (HBcrAg)in prediction of the inflammatory activity and fibrotic level of liver tissue in patients with chronic hepatitis B.Methods Two hundred and eleven patients with chronic hepatitis B,including 125 hepatitis B e antigen (HbeAg)-positive and 86 HBeAg-negative patients, were enrolled in the study.Serum HBcrAg were measured by chemiluminescence enzyme immunoassay.SPSS 16.0 software was used for data processes and statistical analyses.Results In HBeAg-positive patients,serum HBcrAg had a significantly negative correlation with pathological grading and staging (rs = -0.305,P =0.001 和 rs = -0.370,P =0.000),which showed statistically significant differences in different pathological grading and staging (rs = 16.756,P =0.000 和 rs =25.003,P =0.000).In HBeAg-negative patients,serum HBcrAg was significantly positively correlated with pathological grading and staging (rs =0.476,P =0.000 和 rs =0.556,P =0.000),which showed statistically significant difference in different pathological grading and staging (rs =22.529,P =0.000 和 rs =26.416,P =0.000).In HBeAg-positive patients, the areas under the receiver operating characteristic (ROC)curve of serum HBcrAg in prediction of pathological grading ≥G3 and staging ≥S3 were 0.722 and 0.739 (P =0.000 and P =0.000),respectively.The sensitivities,specificities and accuracies in prediction of pathological grading ≥ G3 and staging ≥ S3 were 0.706,0.714,0.712 and 0.821 ,0.698, 0.736,respectively,when the cut-off values of serum HBcrAg were not more than 4.81 ×104 kU/mL and 8.13×104 kU/mL.In HBeAg-negative patients,the areas under the ROC curve of serum HBcrAg in prediction of pathological grading ≥G2 and staging ≥S2 were 0.807 and 0.799 (P =0.000 and P =0.000),respectively.taking serum HBcrAg ≥40.18 kU/mL and ≥10.64 kU/mL as cut-offs,The sensitivities,specificities and accuracies in prediction of pathological grading ≥G2 and staging ≥S2 were 0.821 ,0.724,0.756 and 0.775,0.696,0.733,respectively,when the cut-off values of serum HBcrAg were not less than 40.18 kU/mL and 10.64 kU/mL.Conclusion Serum HBcrAg can effectively predict severe inflammatory activity and severe fibrotic level of liver tissue in HBeAg-positive patients,as well as HBeAg-negative patients.