免疫清除期相同肝实质细胞体积分摊的血清HBV DNA载量与肝组织炎症分级的关系

目的 阐明慢性乙型肝炎自然病程中免疫清除期相同肝实质细胞体积分摊的血清HBVDNA载量水平与肝组织炎症分级的关系. 方法 使用荧光多聚酶链反应分别检测和比较慢性乙型肝炎免疫清除期患者肝组织病理炎症分级1、2、3、4级的血清HBV DNA载量,以及肝组织炎症分级1、2,3、4级所在肝纤维化分期用相同肝实质细胞体积分摊的血清HBV DNA载量.多组资料两两比较采用ANOVA检验分析. 结果 176例处于免疫清除期慢性乙型肝炎患者肝组织病理学炎症分级1、2、3、4级血清HBV DNA载量分别为(8.20×10~5±9.11×10~1)拷贝/ml、(16×10~6±5.96×10~1)拷贝/ml、(8.12×10~5±8.01×10~1)拷贝/ml和(2.08×10~6±3.69×10~1)拷贝/ml,差异无统计学意义(P>0.05).然而,肝组织病理炎症1、2、3、4级所在肝纤维化分期用相同肝脏实质细胞体积分摊后的血清HBV DNA载量分别为(9.24×10~8±9.35×10~2)拷贝/ml、(5.33×10~9±7.56×10~2)拷贝/ml、(1.06×10~(10)±1.77×10~3)拷贝/ml、(3.31×10~(11)± 5.18×10~2)拷贝/ml,差异有统计学意义(P<0.05).结论 在HBV感染的自然病程中,从免疫耐受期进入免疫清除期后,肝细胞反复出现炎症,坏死,同时伴纤维组织增生.不同肝纤维化分期中相同肝实质细胞体积分摊的血清HBV DNA载量水平与肝组织炎症分级有关.

Association between the serum HBV DNA loads normalized to hepatic parenchyma cell volume and the liver histopathologic inflammation grudings in the immune clearance phase

Objective To investigate the relationship between the serum HBV DNA loads normal-ized to hepatic parenchyma cell volume and the liver histopathologic inflammation gradings in the immune clearance phase during the natural history of hepatitis B. Methods Serum HBV DNA loads were deleted by fluorescence polymerase chain reaction and normalized to hepatic parenchyma cell volume. The association between normalized HBV DNA loads and liver inflammation histopathologic grade were analyzed. Results The secrum HBV DNA loads in patients with liver inflammation histopathologic grading 1, 2, 3 and 4 were 8.20×10~5±9.11×10~1, 1.36×10~6±5.96×10~1, 8.12×10~5±8.01×10~1 and 2.08× 10~6±3.69×10~1 copies/ml, respectively (P>0.05). But the secrum HBV DNA loads normalized to hepatic parenchyma cell volume in their located fibrosis stage were 9.24×10~8±9.35×10~2, 5.33×10~9±7.56× 10~2, 1.06×10~(10)±1.77×10~3and 3.31×10~(11)±5.18×10~2 copies/ml, respectively (P<0.05). Conclusion The serum HBV DNA load normalized to hepatic parenchyma cell volume in patients with different fibrosis stages is associated with liver histopathologic inflammation gradings.