HBV相关慢加急性肝衰竭患者血清HBsAg水平与HBV DNA水平及病情严重程度的关系

目的 探讨HBV相关慢加急性肝衰竭(ACLF)患者血清HBsAg水平与HBV DNA水平及病情严重程度的关系.方法 选取慢性乙型肝炎(CHB)患者119例(CHB组)和ACLF患者98例(ACLF组).采用罗氏电化学发光法检测血清HBsAg和HBeAg,荧光定量PCR法检测血清HBVDNA水平.分别比较两组不同HBeAg状态患者的HBsAg和HBV DNA水平差异以及HBsAg和HBV DNA水平的相关性.结果 ACLF组和CHB组患者血清HBeAg阴性患者分别占68.4％(67/98)和42.9％(51/119),差异有统计学意义(P＜0.01).ACLF组血清HBV DNA水平与CHB组比较差异无统计学意义(P＞0.05),两组血清HBeAg阳性患者HBV DNA均高于同组血清HBeAg阴性患者(P＜0.05).ACLF组血清HBsAg水平在血清HBeAg阳性和阴性患者间比较差异无统计学意义(P＞0.05),但均高于CHB组血清HBeAg阳性患者(P＜0.05).血清HBeAg阳性患者血清HBsAg与丙氨酸氨基转移酶、天冬氨酸氨基转移酶具有相关性(P＜0.05),血清HBeAg阴性患者血清HBsAg与血清HBV DNA水平及生化指标无显著相关性(P＞0.05).不同HBV DNA水平ACLF患者中不同HBsAg水平患者的比例比较差异无统计学意义(P＞0.05).结论 HBV相关ACLF患者血清HBsAg水平与HBV DNA水平及病情的严重程度无直接平行关系.

Relationship between HBsAg level and HBV DNA level as well as illness severity in patients with HBV-related acute-on-chronk liver failure

Objective To analyze the relationship between HBsAg level and HBV DNA level as well as illness severity in patients with HBV-related acute-on-chronic liver failure (ACLF).Methods One hundred and nineteen patients with chronic hepatitis B (CHB group) and 98 patients with ACLF(ACLF group) were enrolled.HBsAg and HBeAg were assayed with Roche electrochemical luminescence method.HBV DNA was quantified using a real-time polymerase chain reaction (PCR) assay.HBsAg and HBV DNA levels were compared between two groups and between HBeAg-positive and HBeAg-negative patients in ACLF group respectively,also the correlationbetween HBsAg and HBV DNA was studied.Results The proportions of HBeAg-negative patients were 68.4％(67/98) and 42.9％(51/119) in ACLF group and CHB group respectively,and there was significant difference between two groups (P ＜0.01).There was no significant difference in HBV DNA between two groups (P ＞ 0.05).HBV DNA in HBeAg-positive patients was higher than that in HBeAg-negative patients in two groups(P ＜ 0.05).There was no significant difference in HBsAg between HBeAg-positive patients and HBeAg-negative patients in ACLF group (P ＞ 0.05 ),but they were higher than that in HBeAg-positive patients in CHB group (P＜ 0.05).HBsAg was correlated to ALT,AST in HBeAg-positive patients (P ＜ 0.05).No significant correlation was found among HBsAg and HBV DNA as well as biochemical changes (P＞ 0.05).There was no significant difference in the ratio of different HBsAg levels among the patients of different HBV DNA in ACLF group (P＞ 0.05).Conclusion The level of HBsAg does not directly correlate with serum HBV DNA level,and has no directly correlation with the severity of the disease in patients with HBV-related ACLF.