丙肝患者血清 HCV RNA拷贝数与HCV Ab定量和肝脏功能损伤程度的关系

目的 对丙型肝炎患者丙肝病毒RNA（HCV RNA）、丙肝病毒抗体（HCV Ab）和肝功能指标定量结果进行统计分析,并探讨HCV RNA与HCV Ab和肝功能指标间的关系,为丙肝患者诊断和治疗提供参考依据。方法 收集342例丙肝患者血清,采用实时荧光定量PCR技术检测HCV RNA拷贝数,采用化学发光技术检测HCV Ab浓度,分别采用速率法、免疫比浊法、溴甲酚紫法和重氮盐法检测血清ALT、AST,PA,ALB和TBIL、DBIL的活性或浓度。结果 342例研究对象中,HCV RNA拷贝数以N×10⁶ IU/mL为主,占48.7%;而N×10³ IU/mL和N×10⁴ IU/mL最少,分别占4.3%和7.4%。在HCV RNA拷贝数小于1×10³ IU/mL组中,HCV Ab浓度较其他组低,而HCV RNA拷贝数在N×（10³~10⁷）IU/mL组间时,HCV Ab浓度差异无统计学意义（P>0.05）;当HCV Ab浓度大于10 S/CO时,HCV RNA阳性率升高,可达88.7%。与HCV RNA拷贝数小于N×10³ IU/mL相比,大于N×10⁴ IU/mL的丙肝患者血清ALT、AST、ALB和PA异常率增加（P<0.05）,而血清DBIL和IBIL差异无统计学意义（P>0.05）。结论 丙肝病毒主要损伤肝细胞及其合成功能,联合检测HCV Ab和HCV RNA拷贝数对丙型肝炎的诊断和治疗具有重要的意义。

Association between HCV RNA copies and HCV antibody concentration or liver damage in patients with hepatitis C

Objective To provide data for doctors in diagnosis and treatment for hepatitis C patients through analyzing the association between HCV RNA copies and HCV Ab concentration or liver function tests in serum from hepatitis C patients. Methods Serum samples were collected from 342 hepatitis C patients, HCV RNA copies and HCV Ab concentration were detected by real time fluorescence quantitative PCR and chemiluminescence detection technology, respectively. The activity or concentration of ALT, AST, PA, ALB and TBIL, DBIL in serum were detected by rate method, immunoturbidimetric method, bromocresol violet method and diazonium salt method, respectively. Results HCV RNA copies were concentrated in N×10⁶ IU/mL level in the 342 case of hepatitis C patients, which was accounted for 48.7%, while least in N×10³ IU/mL and N×10⁴ IU/mL levels, accounting for 4.3% and 7.4%, respectively. The concentration of HCV Ab in group of HCV RNA copies less than 1×10³ IU/mL was significantly lower than that of more than 1×10³ IU/mL group, while no significant difference among groups of HCV RNA copies in N×（10³~10⁷）IU/mL（P>0.05）. Moreover, HCV RNA copies were significantly elevated up to 88.7% when patients carried HCV Ab concentration more than 10 S/CO. Compared with the HCV RNA copies less than N×10³ IU/mL, the ALT, AST, PA and ALB concentration were significantly increased in patients who carried HCV RNA copies more than N×10⁴ IU/mL（P<0.05）, while no significant difference of DBIL and IBIL（P>0.05）. Conclusions HCV could damage hepatocytes and interrupt protein synthesis function of liver. It is an important way to enhance the diagnosis and therapy of HCV through combining measure HCV RNA and HCV Ab.