丙肝患者治疗前后HCV RNA与抗-HCV及丙氨酸氨基转移酶水平的分析

目的分析丙型肝炎患者治疗前血清HCV RNA、抗-HCV和丙氨酸氨基转移酶(ALT)水平及治疗后HCV RNA和ALT水平的变化规律。方法对87例丙型肝炎患者血清进行实时荧光定量法(PCR)检测HCV RNA、ELISA法检测抗-HCV和酶速率法检测ALT浓度水平,并对所得数据进行统计学分析。结果丙型肝炎患者血清抗-HCV抗体滴度显著高于健康对照组,大部分患者的ALT水平均有显著性升高;HCV RNA含量与ALT水平具有显著相关性(r=0.673,P0.01),而与抗-HCV的S/OD值无显著相关性(r=0.122,P0.05);在治疗早期,患者HCV RNA含量在第2天显著性下降,而ALT浓度呈一过性上升。结论在HCV诊断与疗效观察中,血清HCV-RNA、抗-HCV和ALT指标各有利弊,3者有机结合在正确诊断和预测肝脏损伤及早期疗效观察中具有重要的临床意义。

Analysis of HCV RNA,anti-HCV and ALT levels in hepatitis C patients before and after treatment

Objective To analyze the variation of serum HCV RNA,anti-HCV and alanine aminotransferase （ALT） levels before treatment,HCV RNA and ALT levels after treatment in patients with hepatitis C.Methods The serum HCV RNA was tested by real-time fluorescent quantitative assay,anti-HCV by ELISA and ALT by enzyme-rate method with the sample from 87 cases of hepatitis C patients.And then,all the data were analyzed statistically.Results Anti-HCV serum antibody titers in hepatitis C patients were significantly higher than that in the control group,and the ALT levels were significantly increased in the majority of patients; HCV RNA and ALT levels were significantly correlated （r = 0.673,P 〈0.01）,but HCV RNA and anti-HCV had no significant correlation （r = 0.122,P〉0.05）.During the early treatment,HCV RNA levels decreased significantly at the first 2 d,while ALT levels rose transiently.Conclusion Each index of HCV-RNA,anti-HCV and ALT has advantages and disadvantages in the diagnosis and therapy of HCV,the right combination of these indexes has important clinical significance in the diagnosis,prediction of liver injury and efficacy of early treatment.