HCV RNA检测与血清病毒学的关系及临床意义分析

目的：探讨丙型肝炎病毒（HCV）RNA检测在HCV单独感染和HCV、乙型肝炎病毒（HBV）合并感染中的临床意义。方法：对129例HCV感染者检测抗-HCV、HCVRNA和总胆红素（TBiL）、谷丙转氨酶（ALT）．并对其中的HCV、HBV合并感染（HBV＋HCV组，27例）和HBV单独感染患者（HBV组，50例）检测HBVDNA。结果：129例HCV感染患者中，抗-HCV和HCVRNA同时阳性者占68．2％，抗-HCV阳性而HCVRNA阴性者占27．9％。抗-HCV阴性而HCVRNA阳性者占3．9％。肝硬化和肝癌组的HCVRNA阳性率84．2％（32／38）较慢性肝炎组的67．0％（61／91）升高（P〈0．05）。ALT和（或）TBiL均异常的HCV患者HCVRNA阳性率79．8％（71／89）较ALT和TBiL均正常者的55．0％（22／40）升高（X^2=8．42，P〈0．01）。在HCV和HBV合并感染组，HCVRNA阳性率55．6％（15／27）低于单纯HCV感染组的76．5％（78／102），差异有统计学意义（P〈0．05），HBVDNA的阳性率29．6％（8／27）低于单纯HBV感染组的76．0％（38／50），差异有统计学意义（P〈0．01）。结论：在HCVRNA检测的同时，结合多项血清病毒学和一些生化相关指标分析，对HCV感染的临床诊治有重要的指导意义。

Clinical Significance and Relationship between HCV RNA and Other Serological Markers in Patients Infected with Hepatitis C

Objective: To investigate the clinical significance of HCV RNA in patients infected with HCV and co-infection by HCV and HBV. Methods: One hundred and twenth-nine HCV cases and 50 control subjects were detected for anti-HCV, HCV RNA, totalbilirubin(TBiL), alanine transamin ase(ALT) and HBV DNA. Results: The positive rates of anti-HCV(+) and HCV RNA(+), anti-HCV(+) and HCV RNA(-), anti-HCV(-) and HCV RNA(+) were 68.2% (88/129), 27.9% (36/129), and 3.9% (5/129) respectively. The positive rate of HCV RNA in group [liver cirrhosis(LC)+hepatocellular carcinoma(HCC)] was higher than that in group chronic hepatitis(CH). The abnormity rate of ALT and TBiL has a distinct relationship with the positive rate of HCV RNA (P < 0.01). In the group of co-infection by HCV and HBV, the positive rates of HCV RNA and HBV DNA were significantly decreased than those of single HCV and HBV groups (P < 0.05 , P < 0.01). Conclusion: The HCV RNA assay accompanying tests of other serological markers is useful for the diagnosis and therapy of HCV patients.