摘要
目的 探讨慢性乙型肝炎病毒(HBV)感染者的疾病自然进程中血清HBV RNA与乙肝病毒学标志物及肝功能炎症指标的相关性.方法 选取2022年6月-2023年6月于浙江中医药大学附属杭州市西溪医院门诊及住院部就诊的慢性HBV感染者221例,均未经抗病毒治疗,包括乙肝E抗原(HBeAg)阳性的患者168例和HBeAg阴性患者53例,通过检测血清HBV RNA定量,观察其不同疾病自然进程中的变化,并分析其与HBV DNA、乙肝表面抗原(HBsAg)、HBeAg、谷丙转氨酶(ALT)、谷草转氨酶(AST)、谷酰转肽酶(GGT)的相关性.结果 HBeAg 阳性患者 HBV RNA、HBV DNA、HBsAg、HBeAg、ALT、AST、GGT 均高于 HBeAg 阴性患者,但HBeAg阳性组白蛋白水平低于HBeAg阴性组(P＜0.05);HBeAg阳性组中,血清HBV RNA与HBV DNA(r=0.710)、HBsAg(r=0.526)、HBeAg(r=0.373)呈正相关;在 HBeAg 阴性组中,血清 HBV RNA 与 HBV DNA(r=0.843)、HBsAg(r=0.566)、ALT(r=0.610)、AST(r=0.626)、GGT(r=0.464)呈正相关.结论 血清 HBV RNA与HBV DNA、HBsAg具有相关性,且在HBeAg阳性和HBeAg阴性患者中均存在;血清HBV RNA与ALT、AST、GGT具有中等程度的相关性,但这种相关性只在HBeAg阴性患者中存在.患者的抗HBV免疫应答可通过清除感染肝细胞来有效地抑制HBV的复制,而患者的免疫应答则更多的与肝组织的炎症损伤有关.
Abstract
OBJECTIVE To investigate the correlation between serum HBV RNA and hepatitis B virological mark-ers and liver function inflammatory indexes in the natural course of disease in chronic hepatitis B virus(HBV)in-fected patients.METHODS A total of 221 patients with chronic HBV infection admitted to the outpatient depart-ment and inpatient department of Hangzhou Xixi Hospital affiliated to Zhejiang Chinese Medicine University from Jun.2022 to Jun.2023 were selected,and none of these patients received ant-iviral treatment,including 168 pa-tients with HBeAg-positive and 53 patients with HBeAg-negative,and quantitative serum HBV RNA was detec-ted to observe its changes in the natural course of different diseases,and its correlation with HBV DNA,HBsAg,HBeAg,ALT,AST and GGT was analyzed.RESULTS The HBV RNA,HBV DNA,HBsAg,HBeAg,ALT,AST and GGT of HBeAg-positive patients were significantly higher than those of HBeAg-negative patients,while the albumin level of HBeAg-positive group was lower than that of HBeAg-negative group(P＜0.05).Serum HBV RNA was positively correlated with HBV DNA(r=0.710),HBsAg(r=0.526)and HBeAg(r=0.373)in the HBeAg positive group.In HBeAg negative group,serum HBV RNA was positively correlated with HBV DNA(r=0.843),HBsAg(r=0.566),ALT(r=0.610),AST(r=0.626),and GGT(r=0.464).CONCLUSION Ser-um HBV RNA was strongly and moderately correlated with HBV DNA and HBsAg,which was presented in both HBeAg-positive and HBeAg-negative patients.Serum HBV RNA was moderately correlated with ALT,AST and GGT,but this correlation was only presented in HBeAg-negative patients.The patient's anti-HBV immune re-sponse could effectively inhibit HBV replication by clearing the infected hepatocytes,whereas the patient's immune response was more related to the inflammatory damage of the liver tissue.
基金项目
国家艾滋病和病毒性肝炎等重大传染病防治专项(十三五)(2017ZX10302201-001)
杭州市生物医药和健康产业发展扶持科技专项(2021WJCY366)
NETL
NSTL
万方数据