丙肝患者在治疗过程中血清RNA与抗HCV定量检测及其生化指标的相关性研究

目的比较不同实验诊断方法在丙型肝炎(丙肝)检测中的应用价值,了解丙型肝炎病人在治疗过程中HCV-RNA含量与血清ALT、前白蛋白、胆红素等生化指标变化的相关性。并探讨HCV RNA定量与ALT、PA、TBIL指标之间的关系。方法对57例丙型肝炎分别采用酶联免疫吸附试验(ELISA)、增强化学发光法(CIA)和荧光定量聚合酶链反应(RFQ-RT-PCR)进行检测,应用AU2700型自动生化仪及其生化检测试剂检测全部标本ALT、PA、TBIL指标。结果ELISA、CIA及PCR方法检测样本丙肝阳性率分别为77.2%、78.9%和84.2%;三组χ2检验没有统计学意义,HCVRNA含量呈阳性的样本中,ALT异常率与HCVRNA含量间呈正相关P<0.01,而ALT数值的变化与HCV RNA含量并无相关性(P>0.05)。PA在治疗前后升高差异显著(P<0.05),可与HCVRNA、ALT联合监测丙肝治疗过程中肝功变化。结论 ELISA诊断试剂盒较CIA法检测丙肝抗体同样具有较高的灵敏度和准确性,在临床诊断中联合PCR检测HCVRNA能提高HCV感染诊断的阳性率;HCVRNA含量反映了病毒复制的活跃程度和患者的病程变化,并且在丙肝治疗进程中能与ALT、PA联合监测疗效。

Study on Quantitative Detection and Biochemical Indicators of Anti- HCV and Serum RNA in the Treatment of Hepatitis C

Objective To evaluate the clinical significance of different methods in detecting HCV antibodies and the relationship of Hepatitis C virus RNA(HCV RNA),alannine aminotransferase(ALT),Prealbumin(PA) and other biochemical changes of Hepatitis C patients during the treatment.Methods 57 patients with hepatitisc were detected by ELISA,CIA and RFQ-RT-PCR,ALT,PA TBIL indicators in all specimens were tested by AU2700 automatic biochemical analyzer and biochemical detection reagent.Results The positive rate of ELISA,CIA and polymerase chain reaction(PCR) were 77.2%,78.9% and 84.2%,respectively.Three groups of chi-square test was not statistically significant.The ALT abnormal rate was positively correlated with content of HCVRNA in specimen which the content of HCVRNA was positive(P<0.01).However,ALT levels was not correlated with the quantity of HCV RNA(P>0.05).PA was significant differences between pre-and post-treatment(P<0.05).It can be used in the monitor of changes of liver function in the process of HCV treatment.Conclusion ELISA and CIA have the same sensitivity and accuracy in the detection of hepatitis C antibody and can improve the HCV infection rate with the detection of HCVRNA.The content of HCVRNA reflects the changes of HCV activity and viral replication in patients and can monitor curative effect with ALT,PA during treatment.