慢性乙型肝炎患者PLT、PAIg、HBVDNA载量的检测及关系探讨

目的：探讨慢性乙型肝炎患者PLT与HBVDNA载量及血小板相关抗体（PAIgG、PAIgA、PAIgM）的相关性并将两者进行比较,为慢性乙型肝炎伴血小板减少患者的诊治提供科学依据。方法：选取60例慢性乙型肝炎无脾亢住院患者作为研究对象,按照2000年全国病毒性肝炎防治方案制定的诊断标准,分为慢性肝炎轻度组、中度组和重度组,观察抗病毒药物干预前后各指标的变化,选取30例健康人作为正常对照组,采用实时荧光定量PCR方法检测HBVDNA载量,用ELISA方法检测PAIg,用全血细胞仪检测PLT。对所得的结果采用SPSS10.0进行比较分析。结果：慢性乙型肝炎患者用药前各组循环血液中PLT含量明显低于正常对照组（P〈0.05）,且随病情的加重而减少,慢性肝炎轻、中、重患者血中检测到HBVDNA,且随病情的加重而增高（P〈0.05）。而对照组未检测到HBVDNA,各组明显高于正常对照组（P〈0.05）,随病情的加重而增高。用药后慢性肝炎轻、中、重患者各组中PLT值均回升,与用药前相比差别有统计学意义（P〈0.05）,HBVDNA载量明显下降,其中慢性肝炎轻度患者HBVDNA消失。3组间PAIg值用药前后与正常对照组比较,均差异无统计学意义（均P〉0.05）。观察组用药前后PLT与HBVDNA呈负相关（r为-0.817和-0.902,P〈0.01）,而与PAIg各值明显相关。结论：慢性乙型肝炎无脾亢患者PLT与PAIg无关,与HBVDNA载量呈负相关。建议临床上可按不同阶段针对不同因素治疗血小板下降,未出现脾亢时以保肝、护肝、抗病毒为主,出现脾亢的患者血小板下降时主要针对脾亢进行治疗。

Relationship Study between platelet,platelet associated immunoglobulin and HBVDNA in patients with chronic hepatitis B with platelet reduction

Objective:To compare platelet(PLT),platelet associated immunoglobulin(PAIg,PAIgG,A,M)and HBVDNA in order to provide the treatment evidence for patients with chronic hepatitis B(CHB)with platelet-reduction.Method:The study included 60 patients with chronic hepatitis B without hypersplenia from July 2008 and September 2009 in Department of Liver,the third clinic hospital,Three Gorges university.According to diagnostic criteria of National virus hepatitis control program,all of them were divided into mild,mode...