乙型肝炎病毒标志物不同模式与血清丙氨酸转氨酶相关分析

目的探讨乙型肝炎病毒(HBV)核心抗体IgM(HBc IgM)和HBV血清标志物不同模式的乙型肝炎核酸(HBV DNA)阳性者血清丙氨酸转氨酶(ALT)的变化。方法采用酶联免疫吸附试验(ELISA)和酶速率法检测1093例HBV DNA阳性者血清病毒标志物和ALT,根据HBV血清标志物不同模式进行分组,比较各组间ALT值。结果各组ALT>60U/L(异常)例数及其异常增高百分率分别为:A组(HBc IgM阳性及乙型肝炎表面抗原、e抗原、核心抗体阳性)147例,占53.85%(147/273);B组(HBc IgM及乙型肝炎表面抗原、e抗体、核心抗体阳性)104例,占42.28%(104/246);C组(HBc IgM、乙型肝炎核心抗体阳性,乙型肝炎表面抗体、e抗体阴性或阳性)6例,占20.69%(6/29);D组(HBc IgM阴性,乙型肝炎表面抗原、核心抗体阳性,乙型肝炎e抗原、e抗体阴性或阳性)125例,占22.94%(125/545)。A组与B组、C组、D组间ALT异常增高率差异均有显著性(均P<0.01);B组与C组、D组间ALT异常增高率差异亦均有显著性(分别P<0.05,P<0.01);C组与D组间ALT异常增高率差异无显著性(P>0.05)。结论HBV DNA阳性患者中的HBc IgM阳性且HBsAg阳性者较HBc IgM阴性者或HBsAg阴性者ALT明显增高。

Correlation analysis of different patterns of HBV markers and the change of alanine transaminase in serum

Objective To evaluate the relationship between the different patterns of HBV markers and the change of alanine transaminase(ALT) in serum of the HBV DNA positive patients.Methods HBV markers and ALT in serum of 1903 cases with positive HBV DNA were respectively detected by ELISA and enzyme rate assay.According to the different HBV markers,these cases were divided into four groups,ALT in four groups were compared.Results The number of abnormal cases with ALT over 60U/L and the percent of these cases in each group were 147(53.85%,147/273) in group A(positive in HBc IgM,HBsAg,HBeAg and HBcAb),104(42.28%,104/246) in group B(positive in HBc IgM,HBsAg,HBeAb and HBcAb),6(20.69%,6/29) in group C(positive in HBc IgM and HBcAb and positive or negative in HBsAb and HBeAb),and 125(22.94%,125/545) in group D(negative in HBc IgM,positive in HBsAg and HBcAb and positive or negative in HBeAg and HBeAb).There was significant difference in ALT between group A and B,group C and D(P<0.01),there was also obvious difference in ALT between group B and C or D(P<0.05,P<0.01,respectively),but there is no statistical significance between group C and D(P>0.05).Conclusion ALT of the cases with both positive HBc IgM and HBsAg is significantly higher than those negative HBc IgM or HBsAg.