【摘要】：目的探討乙型肝炎病毒對(duì)不同免疫階段慢性乙型肝炎患者肝功、肝纖維化以及肝臟病理分期的影響。方法回顧性分析蘭州大學(xué)第一醫(yī)院確診為慢性乙型肝炎的患者657例,采用全自動(dòng)生化分析儀檢測(cè)肝功能指標(biāo),采用全自動(dòng)γ-放射免疫分析儀檢測(cè)肝纖維化指標(biāo),采用全自動(dòng)熒光定量PCR分析儀檢測(cè)被測(cè)者的病毒載量,用方差分析比較在不同免疫階段乙型肝炎病毒對(duì)慢性乙型肝炎患者肝功、肝纖維化的影響,用線性趨勢(shì)卡方檢驗(yàn)分析在不同免疫階段乙型肝炎病毒對(duì)慢性乙型肝炎患者肝臟病理分期的影響。結(jié)果在ALT正常組中,乙型肝炎病毒對(duì)肝功、肝纖維化的影響較弱,而在丙氨酸氨基轉(zhuǎn)移酶(ALT)異常組中,乙型肝炎病毒對(duì)肝功、肝纖維化有明顯影響,且以ALT≥正常上限2倍組中為甚。具體表現(xiàn)為隨著病毒載量的增加,肝功能指標(biāo)中ALT、天門(mén)冬氨酸氨基轉(zhuǎn)移酶(AST)、總膽紅素(TBiL)、直接膽紅素(DBiL)、間接膽紅素(IBiL)增高,總蛋白(TP)、白蛋白(ALB)降低,肝纖維化指標(biāo)中透明質(zhì)酸(HA)、層粘連蛋白(LN)、Ⅲ型膠原(PcⅢ)、Ⅳ型膠原(CⅣ)均增高(P0.05)。在ALT正常組中,乙型肝炎病毒的載量高低與肝臟病理分期無(wú)相關(guān)性聯(lián)系,而在ALT異常組中,特別是ALT≥正常上限2倍組中乙型肝炎病毒的載量高低與肝臟病理分期有顯著相關(guān)性聯(lián)系。結(jié)論乙型肝炎病毒在機(jī)體的不同免疫階段對(duì)肝臟功能的影響是不同的,這為臨床抗病毒治療提供了循證醫(yī)學(xué)證據(jù)。
[Abstract]:Objective to investigate the effect of hepatitis B virus (HBV) on liver function, hepatic fibrosis and liver pathological staging in patients with chronic hepatitis B at different immune stages. Methods 657 patients with chronic hepatitis B diagnosed in the first Hospital of Lanzhou University were analyzed retrospectively. Liver function indexes were detected by automatic biochemical analyzer and hepatic fibrosis index was detected by automatic 緯 -radioimmunoassay. Automatic fluorescent quantitative PCR analyzer was used to detect the viral load of the subjects. The effect of hepatitis B virus on liver function and liver fibrosis in patients with chronic hepatitis B was compared by variance analysis. The effect of hepatitis B virus (HBV) on liver pathological stage in patients with chronic hepatitis B was analyzed by linear trend chi-square test. Results in the normal group of ALT, the effect of hepatitis B virus on liver function and liver fibrosis was weak, while in the group with abnormal alanine aminotransferase (ALT), hepatitis B virus had obvious effect on liver function and hepatic fibrosis. Especially in the group with ALT 鈮，

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