目的 分析慢性乙型肝炎病毒（HBV）感染者HBV-DNA载量及其与肝纤维化和肝功能的关联性。方法 选取复旦大学附属中山医院厦门医院2017年8月至2022年10月住院部收治的78例慢性乙肝患者为研究对象。采用荧光定量聚合酶链反应法检测纳入对象的血清HBV-DNA载量,HBV-DNA载量≥100 IU/mL划分为研究组,HBV-DNA载量<100 IU/mL划分为对照组,检测两组患者的肝纤维化指标和肝功能指标,采用Spearman相关分析HBV-DNA载量与肝纤维化和肝功能指标的关系。结果 研究组患者的ALT、AST、TBIL、DBIL、γ-GT、ALP、TBA值高于对照组（P<0.05）,PCⅢ,IV-C,LN,HA水平均高于对照组（P<0.05）。Spearman相关分析结果显示,慢性乙型肝炎患者HBV-DNA载量与肝功能指标ALT、AST、TBIL和肝纤维化指标DBIL、PCⅢ、IV-C、LN呈正相关性（P<0.05）。结论 慢性乙型肝炎患者HBV-DNA病毒载量与肝纤维化及其肝功能之间均有着密切关系,有望将其联合使用从而改善对疾病的诊断效能,临床可据此评估肝纤维化进展、病情严重程度。
Abstract
Objective To analyze HBV-DNA load and its relationship with liver fibrosis and liver function in chronic hepatitis B virus (HBV) infected patients. Methods Seventy-eight patients hospitalized with chronic hepatitis B admitted to the inpatient department of Zhongshan Hospital, Fudan University (Xiamen Branch), from August 2017 to October 2022 were selected for the study. The fluorescence quantitative polymerase chain reaction method was used to detect serum HBV-DNA load, and the patients of HBV-DNA load≥100 IU / mL were assigned in the study group, and the patients of HBV-DNA load<100 IU / mL for the control group. Then liver fibrosis indexes and the functional performance indexes, and Spearman correlation analysis was used to analyze the relationship between HBV-DNA loads and hepatic fibrosis and functional performance indicators. Results Patients in the study group had higher values of ALT, AST, TBIL, DBIL, γ-GT, ALP, and TBA than those in the control group (P<0.05), and higher levels of PC III, IV-C, LN, and HA than those in the control group (P<0.05). The results of the Spearman's correlation analysis revealed that patients with chronic hepatitis B HBV-DNA load were positively correlated with liver function indexes ALT, AST, TBIL,and liver fibrosis indexes DBIL, PCⅢ, IV-C, LN (P<0.05). Conclusions There is a close relationship between HBV-DNA viral load, liver fibrosis ,and liver function in patients with chronic hepatitis B. It is expected to improve the diagnostic efficacy of the disease by combining the detection of HBV-DNA viral load and liver fibrosis, and the clinic can evaluate the progress of liver fibrosis and the severity of the disease accordingly.
关键词
乙型肝炎病毒 /
DNA载量 /
肝纤维化 /
肝功能 /
关联性
Key words
Hepatitis B virus /
DNA load /
Liver fibrosis /
Liver function /
Association
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 庄辉. 消除乙型肝炎进展[J]. 临床肝胆病杂志,2024,40(5):857-860.
[2] 宋林,张锦伟,韩亚男. 乙型肝炎病毒低病毒载量与血清标志物表达研究[J]. 中国医药指南,2021,19(30):49-51.
[3] 符振旺,范世恒,李卫霞. 海南省2015—2021年乙型肝炎流行病学特征分析及趋势预测[J]. 中国热带医学,2024,24(2):143-149.
[4] 吴丹,张锡坚,陈伟. 乙肝肝硬化患者血清HBV-DNA水平与肝功能、CEA及AFP水平的相关性[J]. 海南医学,2022,33(21):2815-2817.
[5] 郭金芳. 实时荧光定量PCR技术定量检测乙型肝炎病毒DNA效果评价[J]. 实验室检测,2024,2(11):164-166.
[6] 李剧,许琳婧,韩亚男. 慢性乙型肝炎后肝硬化患者血清中HBV-DNA病毒载量表达水平与肝纤维化肝纤四项的关系[J]. 中国医药指南,2021,19(31):119-120,125.
[7] 黄滨宁. 乙型肝炎肝硬化患者血清LN、HA、CⅣ、PⅢ、CHI3L1水平对肝纤维化程度的评估价值[J]. 中国医药指南,2024,22(34):37-39.
[8] 刘娟,杜红,任秀华,等. 术前总胆红素水平与肝切除术后患者肝功能恢复的相关性[J]. 临床消化病杂志,2022,34(3):179-184.
[9] 黄凯. 血清生化指标检测在乙型肝炎后肝硬化中的诊断价值分析[J]. 现代诊断与治疗,2024,35(4):595-597.
[10] 储晓,邓慧,戴刚. 血清生化指标联合检测对乙型肝炎病情诊断的准确性研究[J]. 系统医学,2023,8(24):5-8.
[11] Li L,Li B,Zhang M.HBV DNA levels impact the prognosis of hepatocellular carcinoma patients with microvascular invasion[J]. Medicine (Baltimore),2019,98(27):e16308.
[12] 吴清艳,陈柳虹,王日,等. HBeAg(+)与(-)HBV感染者HBV-DNA载量及其与肝纤维化和MELD评分的关系[J]. 中华医院感染学杂志,2023,33(14):2096-2099.
[13] 中华医学会肝病学分会,中华医学会感染病学分会. 慢性乙型肝炎诊断标准(2010年版)[J]. 中西医结合肝病杂志,2011,21(2):121-122.
[14] 陶学萍,李丽娇,漆阳红,等. 提高HBV DNA灵敏度检测对慢性乙型肝炎低病毒血症的临床价值[J]. 中国医药指南,2023,21(33):1-4.
[15] 钟欢妹,何玉花,陈丹娜,等. 高灵敏度HBV DNA检测在乙型肝炎相关性肝细胞肝癌中的临床应用价值研究[J]. 中国医药指南,2024,22(9):59-61.
[16] 黄瑶. 贵州省少数民族地区人群吸烟、饮酒与乙型肝炎流行及肝功能关联的现况研究[D]. 贵州医科大学,2021.
[17] 古芳芳. 慢性乙型肝炎患者血清肝纤维化指标与HBV-DNA病毒载量的相关性分析[J].江西医药,2023,58(5):598-600.
[18] 何伟,田水林,施卫兵. 不同年龄段慢性乙型肝炎患者乙肝相关指标与肝纤维化的相关性研究[J]. 中国医刊,2023,58(12):1307-1312.
[19] 叶晓晓,杨海飞,张赛君. 不同HBV DNA载量慢性乙型肝炎患儿肝脏病理肝功能及血纤维化指标变化对照研究[J]. 中国妇幼保健,2021,36(8):1790-1792.
基金
上海市加强公共卫生体系建设三年行动计划（2023—2025年）优青项目（GWVI-11.2-YQ56）
PDF(645 KB)
