慢性乙型肝炎患者肝组织中HBV DNA载量相关因素分析

目的 探讨慢性乙型肝炎（CHB）患者肝组织HBV DNA载量和血清及外周血单个核细胞（PBMC）内病毒载量、肝组织炎症活动度（G）、纤维化分期（S）、血清丙氨酸氨基转移酶（ALT）等的相关性。方法 50例CHB患者均接受肝活检。部分肝组织行常规病理检查，另应用荧光定量PCR定量检测部分肝组织、PBMC与血清中病毒载量。同时检测患者血清ALT水平。结果 直线相关分析显示，肝组织中与血清中病毒载量高度正相关（r=0．77977，P〈0．0001）；与PBMC中病毒载量中度正相关（r=0．53855，P〈0．0001）。另外与血清ALT水平呈低度正相关，与肝组织G、S无明显相关性。逐步回归分析方程为Y=0．54960X1＋0．83890X2-0．36643X3＋0.00174X4（Y：肝组织病毒载量；X1：血清病毒载量；X2：PBMC中病毒载量；X3：纤雏化分期；X4：血清ALT水平）。结论 CHB患者血清中和PBMC中病毒载量可用于推测肝组织中病毒载量水平。

Analysis of correlation factors of intrahepatic hepatitis B virus DNA load in patients with chronic hepatitis B

Objective To evaluate the correlation of intrahepatic HBV DNA load with the HBV load in serum and peripheral blood mononuclear cells(PBMC)and the stage of fibrosis,grade of inflammation,level of serum ALT and AST.Methods Liver specimens were taken from 50 patients by percutaneous needle biopsy and divided into two parts:one was processed for histological examination,and the other was used for molecular biology analyses.HBV DNA load was measured with fluorescent quantitative polymerase chain reaction(FQ-PCR).The data of serum level of ALT and AST were collected.Results A high correlation between intrahepatic HBV-DNA load and serum virus load was found(r=0.77977,P<0.0001).The intrahepatic HBV-DNA load moderately positively correlated with PBMC virus load(r=0.53855,P<0.0001),and slightly correlated with ALT and AST levels.By stepwise regression analysis it was found that the intrahepatic virus load was closely related with viral load in PBMC and serum,stage of fibrosis and levels of ALT.Conclusions The results of this study indicates that serum virus load,PBMC virus load,serun ALT level and fibrosis stage can be used to speculate intrahepatic virus load.