血清HBVDNA定量与肝组织病理的相关性研究

目的明确慢性乙型病毒性肝炎(CHB)患者血清HBV DNA定量与肝组织炎症活动度及肝纤维化分期之间的关系。方法 CHB患者223例分成HBeAg阴性和阳性两组,应用PCR检测血清HBV DNA,同时行肝组织病理检查明确肝组织炎症活动度和肝纤维化分期。结果 (1)HBeAg阳性组不同肝组织炎症活动度分级之间的HBVDNA无明显的差别(P0.05),而且二者无明显相关性(rs=-0.073,P0.05);不同肝纤维化分期之间的HBVDNA也无明显的差别(P0.05),而且二者也无相关性(rs=-0.113,P0.05)。(2)HBeAg阴性组不同肝组织炎症活动度分级之间的HBVDNA有明显的差别(P0.05),而且二者呈正相关(rs=0.327,P0.01);不同肝纤维化分期之间的HBVDNA也有明显的差别(P0.05),而且二者也呈正相关(rs=0.314,P0.01);随着肝组织炎症分级和肝纤维化分期的增加,HB-VDNA进行性增高。结论 HBeAg阴性CHB患者的血清HBV DNA定量与肝组织炎症活动度及肝纤维化分期具有良好的一致性;HBeAg阳性CHB患者的HBV DNA定量不能反映肝组织病理情况。

Research of correlation of serum HBVDNA quantitation and liver tissue pathology in chronic hepatitis B

Objective To identify correlation of serum HBVDNA quantitation and grades of liver tissue inflammation or stages of liver fibrosis in chronic hepatitis B（CHB）.Methods Two hundred and twenty-three patients who included group of HBeAg positive（134 cases） and group of HBeAg negative（89 cases） were detected serum HBVDNA quantitation by PCR and liver tissue pathology checking to determine grades of liver tissue inflammation and stages of liver fibrosis in CHB.Results（1）There were no differences with HBVDNA quantitation in different grades of liver tissue inflammation or stages of liver fibrosis（P0.05） and no correlation between serum HBVDNA quantitation and grades of liver tissue inflammation or stages of liver fibrosis（P0.05）in group of HBeAg positive.（2） There were significant differences with HBVDNA quantitation in different grades of liver tissue inflammation or stages of liver fibrosis（P0.05） and positive correlation between serum HBVDNA quantitation and grades of liver tissue inflammation or stages of liver fibrosis（P0.01）in group of HBeAg negative.HBVDNA quantitation was increasing progressively with the raising of grades of liver tissue inflammation or stages of liver fibrosis.Conclusion There is well concordance between serum HBVDNA quantitation and grades of liver tissue inflammation or stages of liver fibrosis in HBeAg negative CHB.Serum HBVDNA quantitation can not response the status of liver tissue pathology in HBeAg positive CHB.