不同HBV感染自然史状态及肝硬化患者抗-HBc水平及其临床意义

发布时间：2018-03-08 02:01

  本文选题：肝炎病毒　切入点：乙型　出处：《重庆医学》2017年21期 　论文类型：期刊论文

【摘要】：目的研究慢性乙型肝炎病毒(HBV)感染不同自然史状态及肝硬化患者血清乙型肝炎病毒核心抗体(抗-HBc)水平及其用于自然史状态区别诊断的临床价值。方法纳入2015年3月至2016年6月就诊的慢性HBV感染患者160例,根据自然史状态分为免疫耐受组(n=43)、乙型肝炎病毒e抗原(HBeAg)阳性慢性乙型肝炎(CHB)组(n=37)、非活动携带组(n=39)及HBeAg阴性CHB组(n=41),同时纳入HBeAg阳性(n=44)及阴性肝硬化患者(n=46)。收集患者一般情况,检测血清乙型肝炎病毒表面抗原(HBsAg)、HBeAg、抗-HBc、HBV DNA载量及HBV基因型。分析抗-HBc与临床指标的相关性及其用于自然史状态区别诊断的价值。结果不同自然史状态抗-HBc由高至低为:HBeAg阳性CHB组(4.22±0.68)log_(10)IU/mL、HBeAg阴性CHB组(3.89±0.88)log_(10)IU/mL、非活动携带组(3.07±0.68)log_(10)IU/mL及免疫耐受组(2.88±0.82)log_(10)IU/mL。HBeAg阳性及阴性肝硬化患者抗-HBc分别为(3.04±0.82)、(3.15±0.86)log_(10)IU/mL。HBeAg阳性CHB组抗-HBc与ALT(r=0.353,P=0.032)及AST(r=0.421,P=0.009)呈正相关;HBeAg阴性CHB组抗-HBc与HBV DNA(r=0.343,P=0.028)、ALT(r=0.458,P=0.003)及AST(r=0.495,P=0.001)呈正相关。抗-HBc区别诊断免疫耐受状态及HBeAg阳性CHB的AUC为0.903,区别非活动携带状态及HBeAg阴性CHB的AUC为0.833。结论不同慢性HBV感染自然史状态下血清抗-HBc水平存在明显差异,且抗-HBc可用于慢性HBV感染自然史状态的区别诊断,诊断价值高于HBsAg水平。
[Abstract]:Objective to study the chronic hepatitis B virus (HBV) infection in patients with different natural history of hepatitis and cirrhosis of hepatitis B virus core antibody (anti -HBc) level and its clinical value for diagnosis of natural history status differences. Methods 160 patients were included from March 2015 to June 2016 were infected with chronic HBV, according to the natural history of the state is divided into immune tolerance group (n=43), hepatitis B virus e antigen (HBeAg) positive chronic hepatitis B (CHB) group (n=37), inactive carrier group (n=39) and HBeAg negative group CHB (n=41), and HBeAg (n=44) into positive and negative patients with liver cirrhosis (n=46). The general condition of patients were collected for detection of serum hepatitis B virus surface antigen (HBsAg), HBeAg, anti -HBc, HBV DNA load and HBV genotype. Correlation analysis between anti -HBc and clinical index for natural history and state difference diagnosis. Results different from high to anti -HBc natural history 浣庝负:HBeAg闃虫，

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