血清HBV-DNA载量与转氨酶值及肝纤维化血清学指标相关性研究

目的探讨乙肝患者血清HBV-DNA的表达与肝纤维化及转氨酶之间的关系。方法对361例标本应用荧光定量PCR技术检测HBV-DNA;放射免疫法检测该批标本血清中透明质酸(HA)、黏层蛋白(LN)、Ⅲ型前胶原肽(PⅢNP)、Ⅳ型胶原(Ⅳ-C)4项肝纤维化标志物;对其中267例利用连续监测比色法检测血清中的谷草转氨酶(AST)和谷丙转氨酶(ALT)。结果在HBV中低复制组中,随着患者血清HBV-DNA对数均值上升,肝纤维4项的水平浓度也随之递增;而在HBV高复制组里,患者肝纤维4项水平随病毒复制量增加而有所降低。各组间差异有统计学意义(P<0.05)。AST、ALT两种转氨酶在HBV-DNA阴性对照组与阳性组之间差异有统计学意义(P<0.05),但在HBV-DNA表达阳性的各组中,乙肝患者血清HBV-DNA的载量与AST、ALT两种转氨酶的浓度无关(P>0.05)。结论 HBV复制与肝纤维化血清学指标存在相关性,但不呈直线相关关系;乙肝患者的HBV-DNA复制状态尚不能与肝转氨酶有密切联系。

The correlation between HBV DNA levels,transaminase contents and liver fibrosis markers

Objective To investigate not only the relativity between the expression of HBV-DNA in serum and liver fibrosis in hepatitis B patients,but also the relationship between transaminase and the two former concepts.Methods We investigated the application of nuclear amplificatioin by fluorescence quantitative PCR in detecting HBV-DNA,and the adoption of radioimmunoassay for testing 4 liver fibrosis markers including serum hyaluronic acid（HA）,sticky layer protein（LN）,Ⅲ procollagen（PⅢNP）,Ⅳ collagen（Ⅳ-C） in 362 cases.We also tested the utilization of continuous monitoring method and colorimetric method for measuring serum transaminase in 267 cases.Results In the low HBV viral replication group,with the increase of the serum HBV-DNA on the average,the level of concentration of liver fiber index increased;in the high HBV viral replication group,the four index of liver fibrosis in patients decreased when the amount of viral liver replication increased.There was a significant difference between the results in each group（P〈0.05）.The difference of transaminase including AST,ALT in patients between the HBV-DNA negative control group and positive group was significant（P〈0.05）,but in each of the HBV-DNA positive expression groups,serum HBV-DNA levels from hepatitis B patients had no relationship with the concentration of the two kinds of transaminase（P〉0.05）.Conclusion Correlation exists between HBV replication and the serology index of liver fibrosis,but it is not a linear correlation;the status of HBV-DNA replication in patients is not yet closely linked to the liver transaminase.