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乙肝病毒感染模式与病毒复制及丙氨酸氨基转移酶的关系 被引量:5

Viral replication and ALT level in hepatitis B patients with different patterns of HBV infection
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摘要 目的探讨乙型肝炎病毒(HBV)不同感染模式病毒复制情况以及各模式丙氨酸氨基转移酶(Aminotransferase,ALT)含量差异分析。方法采用酶联免疫吸附试验(ELISA)、荧光定量PCR以及自动化生化分析仪速率法对1 021例乙型肝炎病毒感染者进行HBV血清标志物:HBV表面抗原(HBs Ag)、抗HBV表面抗原-抗体(HBs Ab)、HBV e抗原(HBe Ag)、抗HBV e抗原-抗体(HBe Ab)、HBV核心抗体(HBc Ab),HBV-DNA含量以及ALT检测,并对常见三种模式HBV-DNA含量以及ALT进行差异分析,同时依据血清学免疫指标HBe Ag以及病毒复制情况将资料分为四组:HBe Ag(+)HBV-DNA(+)、HBe Ag(+)HBV-DNA(-)、HBe Ag(-)HBV-DNA(+)、HBe Ag(-)HBV-DNA(-),并对该四组资料肝功能差异进行分析。结果此研究发现HBV感染有7种模式,乙型肝炎患者血清中HBV-DNA阳性百分比为45.25%,ALT〉40 U/L的人群百分比为20.27%,ALT〉120 U/L人群百分比为3.13%;HBe Ag(+)组与HBe Ag(-)两组HBV-DNA阳性百分比差异有统计学意义,两组丙氨酸氨基转移酶异常率差异有统计学意义(P〈0.05)。HBe Ag(-)HBV-DNA(-)组ALT〉40 U/L的人群百分比以及ALT含量均低于其他三组,差异有统计学意义(P〈0.05)。结论HBV血清标志物与HBV-DNA复制情况存在相关性,且与ALT水平密切相关,HBV血清标志物与HBV-DNA能准确地判断HBV复制情况以及其传染性,ALT水平能较好地判断感染人群肝功能情况,三者相结合能给临床的诊断以及疗效观察提供可靠的依据。 Objective To investigate the viral replication among the hepatic B virus (HBV) patients with different infection patterns, and analyze the differences of alanine transaminase (ALT) level in them. Methods Serum samples of 1 021 HBV carriers admitted in the hospital from May 2014 to March 2015 were collected, and then enzyme-linked immunosorbent assay (ELISA) was used to detect the serum markers of hepatitis B virus (including HBsAg, HBsAb, HBeAg, HBeAb and HBcAb). The HBV-DNA levels were qualitatively detected by real-time polymerase chain reaction (PCR), and the ALT levels were determined with a fully-automatic biochemical analyzer. The differences of HBV-DNA and ALT levels were analyzed among the 3 common infection patterns. At the same time, the differences of liver function were analyzed in 4 groups, that is, HBeAg(+) HBV-DNA (+), HBeAg(+) HBV-DNA (-), HBeAg(-) HBV-DNA (+), and HBeAg(-) HBV-DNA (-) groups which were assigned according to the serological HBeAg immune markers and viral replication. Results There were 7 infection patterns in the subjected hepatitis B patients, with 45.25% of them positive to HBV-DNA, 20.27% with ALT level〉40 U/L, and 3.13% with ALT level〉120 U/L. Significant differences were found in the positive rates of HBV-DNA and abnormal rates of ALT level between the HBeAg (+) group and HBeAg (-) groups (P〈0.05). The ALT levels and percentage of the patients with ALT〉40 U/L were significantly lower in the HBeAg (-)HBV-DNA (-) group than the other 3 groups (P〈 0.05). Conclusion There is a correlation between HBV serum markers and HBV-DNA replication,which are also associated with the ALT level. HBV serum markers and HBV-DNA can accurately evaluate the HBV replication and infectivity, and ALT level can evaluate liver function in hepatitis B patients. Therefore, the combination of the 3 indicators can provide reliable evidence for clinical diagnosis and therapeutic assessment.
作者 凌利芬 吴正林 李振华 何涛君 陆学东 LING Li-fen, WU Zheng-lin, LI Zhen-hua, HE Tao-jun, LU Xue-dong (Department of Clinical Laboratory, the Fourth People's Hospital of Shenzhen (Affiliated Futian Hospital of Guangdong Medical College ),Shenzhen, Guangdong 518033, China)
出处 《中国热带医学》 CAS 2016年第7期709-712,共4页 China Tropical Medicine
基金 深圳市福田区卫生公益性科研项目(No.FTWS2014006)
关键词 乙型肝炎病毒 乙型肝炎病毒E抗原 乙型肝炎病毒DNA 丙氨酸氨基转移酶 Hepatitis B viruses HBeAg HBV-DNA Alanine transaminase
作者简介 凌利芬(1983-),女,本科,主管技师,研究方向:临床检验方向。 通讯作者:吴正林,E-mail:szwzlwzh@yahoo.com.cn
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