血清HBV-DNA与a-L-岩藻糖苷酶对慢性乙肝病毒感染者临床价值

目的探讨在慢性乙肝病毒感染者中血清HBVDNA水平与a-L-岩藻糖苷酶（AFU）活性的临床价值。方法收集377例慢性乙肝病毒感染者,分为慢性乙型肝炎组233例,肝炎肝硬化组105例,原发性肝癌组39例。其中慢性乙型肝炎组分为轻度组159例、中度组29例、重度组45例,检测血清HBVDNA水平与a-L-岩藻糖苷酶活性并统计分析。结果 （1）在所有病例中,慢性乙型肝炎组HBV-DNA水平最高,其次肝炎肝硬化组,原发性肝癌组最低,3组间两两比较,慢性乙型肝炎组其他2组比较有显著性差异P〈0.01;而3组间AFU水平无显著差异,P〉0.05。（2）在慢性乙型肝炎组中,轻度组HBVDNA水平最高,其次中度组,重度组为最低,3组间两两比较,轻度组与重度组HBV-DNA水平比较有显著差异性,P〈0.01;重度组血清AFU活性水平最高,其次中度组,轻度组最低,3组间两两比较,轻度组与中度、重度组血清AFU活性水平比较有差异性,P〈0.05。结论慢性乙肝病毒感染者的肝脏损害程度与HBV-DNA水平、AFU的活性有密切关系,联合检测HBV-DNA水平、AFU活性可以作为乙肝病毒感染者肝脏炎症程度的指标,受肝脏炎症活动影响,AFU作为肝癌血清标志物特异性较差。

Diagnostic Value of HBVDNA and AFU in the Patients Infected by Chronic Hepatitis B

Objective To investigate the clinic value of the serum HBV DNA level and a-L-fucosidase(AFU) level in hepatitis B patients.Methods Coded serum samples obtained from 159 patients with mild chronic hepatitis,29 patients with moderate chronic hepatitis,45 patients with serious chronic hepatitis,105 patients with liver cirrhosis,39 patients with HCC were examined for HBV DNA and AFU with methods of fluorescent quantitative PCR and radioimmunoassay.Then the data were analyzed by SPSS.Results 1 There were significant differences between chronic hepatitis B, liver cirrhosis and HCC in the levels of HBV DNA,P<0.01; But there were no significant differences between these three groups in the serum AFU activity,P>0.05.2 In chronic hepatitis patients,serum levels of HBV DNA decreased with the severity of disease and there was significant difference between mild and serious groups,P<0.01;Otherwise serum AFU levels increased with the severity of disease and there were significant differences between mild and moderate groups or between mild and serious groups, P<0.05.Conclusion It suggests that there is close relationship between liver damage of chronic hepatitis patients and the serum levels of HBV DNA and AFU activity. Combined detection of AFU and HBV DNA is helpful to estimate the liver damage. Influenced by the liver inflammation, AFU has poor specificity as a serum marker of HCC.