浙江省慢性HBV感染者中乙型肝炎病毒表面抗原（HBsAg）水平的横断面研究

发布时间：2018-06-08 07:12

本文选题：乙肝表面抗原定量(HBsAg) + 慢性HBV感染　；参考：《浙江大学》2014年硕士论文

【摘要】：背景与目的：乙型肝炎病毒表面抗原(HBsAg)是感染乙肝病毒(HBV)的早期标记物,HBsAg定性检测作为筛选工具已经沿用几十年。近年来,HBsAg定量在慢性乙型肝炎病毒(HBV)感染状态评估及预测抗病毒疗效等方面得到了越来越多的关注。本研究的目的是确定浙江省的慢性HBV感染各个阶段HBsAg水平。方法：本研究纳入浙江大学附属第一医院从2012年2月至2013年2月期间门诊及住院共623名患者。根据((2012年欧洲肝脏研究协会(EASL)临床实践指南》、《亚太地区慢性乙型肝炎临床实践指南》和((2010版中国慢性乙型肝炎的临床实践指南》诊断标准,将患者分为免疫耐受期(IT,n=108),免疫清除期(IC,n=161),HBeAg阴性肝炎期(ENH, n=149),低复制期(LR,n=135)和肝硬化期(LC,n=70),对其相关参数进行分析,即乙肝表面抗原定量(雅培ARCHITECT测定法)和HBV-DNA相关性,及与血清ALT/AST在慢性乙型肝炎(CHB)的各个阶段的相关性进行统计学分析。结果：CHB的每个阶段HBsAg中位值之间存在差异(P0.001)：免疫耐受期(4.85log10IU/ml), IC(4.36log10IU/ml), ENH(2.95log10IU/ml), LR(3.18log10IU/ml)和LC (2.69log10IU/ml)。乙肝表面抗原滴度最高的是免疫耐受期,而最低的是肝硬化期。HBsAg与乙肝HBV-DNA相关性最强的是在免疫清除期(r=0.683,P0.001)。同时观察到HBsAg水平和ALT/AST之间没有相关性。结论本研究结论(1)HBsAg滴度HBV感染的五个阶段不同；(2) HBsAg水平在IT期最高在LC最低；(3)在IC期,HBsAg水平与HBVDNA有很强的相关性；(4)基因B型和C型之间的所有五个阶段的HBsAg中位数水平没有明显差异。
[Abstract]:Background & objective: HBsAg, an early marker of HBV infection, has been used as a screening tool for decades. In recent years, more and more attention has been paid to the evaluation of chronic hepatitis B virus (HBV) infection status and the prediction of antiviral efficacy. The aim of this study was to determine the HBsAg levels in all stages of chronic HBV infection in Zhejiang Province. Methods: the study included 623 patients in outpatient and inpatient departments from February 2012 to February 2013 in the first affiliated Hospital of Zhejiang University. According to the guidelines for Clinical practice of EASL (2012 European Association for liver Research), the Asia Pacific Clinical practice Guide for chronic Hepatitis B and the 2010 Chinese Clinical practice Guide for chronic Hepatitis B, The patients were divided into three groups: the immune tolerance phase (ITN) 108D, the immune clearance phase (ICN) 161D HBeAg negative hepatitis (ENH, nr 149m), the low replication stage (LRN) 135) and the cirrhotic stage (LRN) 70). The correlation between the quantitative analysis of hepatitis B surface antigen (Abd) and HBV-DNA was analyzed. The correlation between alt / AST and serum alt / AST in all stages of chronic hepatitis B (CHB) was statistically analyzed. Results there was significant difference in the median value of HBsAg in each stage of ChB (P 0.001): immune tolerance period was 4.85 log10 IUU / ml, IC4.36 log10 IUP / ml, ENH 2.95log10 / ml, LRN 3.18 log10 / ml) and LC 2.69 log10 / ml / ml. The highest titer of hepatitis B surface antigen was in immune tolerance phase, while the highest correlation between HBsAg and HBV-DNA in cirrhosis stage was found in the clearance phase (P 0.001). It was observed that there was no correlation between HBsAg level and alt / AST. Conclusion in this study, there is a strong correlation between HBsAg level and HBV DNA in IT stage, the highest level in IT stage and the lowest level in LC, and there is a strong correlation between HBsAg level and HBV DNA in this study. There was no significant difference in median HBsAg levels in all five stages between type B and type C.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R512.62

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