血清HBV DNA水平及肝脏弹性测量值对HBeAg阴性慢性乙型肝炎肝纤维化程度诊断价值的研究

发布时间：2018-04-29 21:33

  本文选题：HBV + DNA　； 参考：《郑州大学》2015年硕士论文

【摘要】：目的：探索利用血清HBV DNA水平及肝脏弹性测量值(LSM)在预测HBeAg阴性慢性乙型肝炎患者肝纤维化程度中的意义。方法对175例HBeAg阴性慢性乙型肝炎患者行肝脏穿刺病理组织学检查、血清HBV DNA水平检测和肝脏弹性值测定,根据肝脏病理改变,将其纤维化程度分为SO-S4,将S0-S1定义为A组,S2为B组,S3为C组,S4为D组,S0-S1为非显著性肝纤维化,S2-S4为显著性肝纤维化。结果在175例e抗原阴性慢性乙型肝炎患者中,71(41%)例患者无明显肝脏纤维化(S0-S1),94(59%)例患者有显著的肝纤维化(S≥2)。LSM及HBV DNA随着肝纤维化病理分期的增加而增大。采用单因素方差分析比较各组间LSM的均数,差异具有统计学意义(F=120.10,P值0.05),相邻两组间LSM均值差异均具有统计学意义(Z值在-3.578～-2.520之间,P值均0.05)。血清HBVDNA载量在A组与B、C、D组之间的差异具有统计学意义(P均0.05)。利用受试者工作特征曲线下面积(AUROC)分析：LSM、血清HBV DNA诊断肝组织纤维化程度的AUROC分别为0.8、0.7,均显著大于诊断参考线下面积(P均0.05),95%的置信区间(CI)分别为0.642-0.874、0.632-0.769。HBeAg阴性的CHB患者,以血清HBV DNA≥6.053×105IU/ml为界值,其诊断肝脏纤维化程度的灵敏度0.627、准确度分别为0.689、特异度为0.658；以LSM≥8.5kpa为界值,诊断显著纤维化的灵敏度、特异度、准确度分别为0.752、0.895和0.732。结论HBeAg阴性慢性乙型肝炎患者中,血清HBV DNA与肝脏弹性测量值均能预测显著肝纤维化,肝脏弹性测量值价值更大。
[Abstract]:Objective: to explore the significance of serum HBV DNA and liver elasticity in predicting hepatic fibrosis in HBeAg negative chronic hepatitis B patients. Methods 175 patients with HBeAg negative chronic hepatitis B were examined by histopathological examination of liver puncture, serum HBV DNA level and liver elasticity, according to the pathological changes of liver. The degree of fibrosis was divided into SO-S4, S0-S1 was defined as group A, S 2, group B, group S3, group C, group S4, group D, group S0-S1, non-significant hepatic fibrosis, group S2-S4, significant hepatic fibrosis. Results among 175 patients with chronic hepatitis B with e antigen negative, 71g / 41) there was no obvious hepatic fibrosis S _ 0-S _ 1C _ (94) 59) there was significant hepatic fibrosis S 鈮，

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