乙型肝炎患者血清HBV DNA与前白蛋白定量检测的意义

目的探讨乙型肝炎(乙肝)患者HBV DNA与血清前白蛋白(PA)定量检测的意义,比较两者在乙肝中的临床应用价值。方法采用荧光定量PCR法和免疫比浊法,对312例5组携带乙肝不同病毒标志物的慢性乙肝患者进行HBVDNA定量和PA检测。结果临床各型慢性乙肝患者PA水平均降低,组间比较有显著性差异(F=63.97,P<0.05),PA值随肝病病情加重呈进行性下降,下降幅度与肝脏病变严重程度相平行。HBV DNA阳性率与慢性乙肝病情的严重程度不一致,乙肝患者HBV DNA阳性组与阴性组间PA水平及异常率均无明显差异(F=0.86,P>0.05;χ2=2.14,P>0.05),HBV复制组PA水平与HBV不复制组比较,亦无显著性差异(t=0.236,P>0.05)。结论慢性乙肝患者HBVDNA定量检测是了解HBV复制和感染的可靠指标,但HBV DNA不能反映乙肝病情的临床严重程度。血清PA是反映肝细胞受损的敏感指标,对乙肝病情和预后判断有重要价值。PA水平与HBV复制及HBV DNA含量无明显关系。

Significance of Quantitation of Serum HBV DNA and Prealbumin in Patients with Hepatitis B

Objective To study the significance of quantitation of serum HBV DNA and prealbumin(PA) in patients with hepatitis B,and to compare their clinical values in hepatitis B.Method A lotal of 312 patients with chronic hepatitis B was divided into 5 groups based on their different virus markers.HBV DNA and PA were measured by fluorescence quantitative PCR and immune turbidimetry.Results The level of PA decreased in all groups of patients with hepatitis B,and the differences among 5 groups were significant(F=63.97,P<0.05).The level of PA decreased gradually along with the exacerbation of chronic hepatitis B,and the decreasing extent was parallel to the severity of liver lesion.No correlation was found between the positive rate of HBV DNA and the severity of chronic hepatitis B.There was no difference in PA level and their abnormal rate between HBV DNA positive group and negative group in patients with hepatitis B(F=0.86,P>0.05;χ2=2.14,P>0.05).There was no difference in PA level between replication group and nonreplication group of HBV(t=0.236,P>0.05).Conclusions The quantitation of HBV DNA is a reliable item to identify the replication and infection of HBV in patients with hepatitis B,but it cannot reflect the severity of hepatitis B.Serum PA is a sensitive index to reflect the lesior of liver cells and is useful to identify and predict the outcome of hepatitis B.PA level isn't obviously related to the replication of HBV and the concentration of HBV DNA.