發(fā)布時(shí)間：2018-03-08 02:01

  本文選題：肝炎病毒　切入點(diǎn)：乙型　出處：《重慶醫(yī)學(xué)》2017年21期 　論文類(lèi)型：期刊論文

【摘要】：目的研究慢性乙型肝炎病毒(HBV)感染不同自然史狀態(tài)及肝硬化患者血清乙型肝炎病毒核心抗體(抗-HBc)水平及其用于自然史狀態(tài)區(qū)別診斷的臨床價(jià)值。方法納入2015年3月至2016年6月就診的慢性HBV感染患者160例,根據(jù)自然史狀態(tài)分為免疫耐受組(n=43)、乙型肝炎病毒e抗原(HBeAg)陽(yáng)性慢性乙型肝炎(CHB)組(n=37)、非活動(dòng)攜帶組(n=39)及HBeAg陰性CHB組(n=41),同時(shí)納入HBeAg陽(yáng)性(n=44)及陰性肝硬化患者(n=46)。收集患者一般情況,檢測(cè)血清乙型肝炎病毒表面抗原(HBsAg)、HBeAg、抗-HBc、HBV DNA載量及HBV基因型。分析抗-HBc與臨床指標(biāo)的相關(guān)性及其用于自然史狀態(tài)區(qū)別診斷的價(jià)值。結(jié)果不同自然史狀態(tài)抗-HBc由高至低為:HBeAg陽(yáng)性CHB組(4.22±0.68)log_(10)IU/mL、HBeAg陰性CHB組(3.89±0.88)log_(10)IU/mL、非活動(dòng)攜帶組(3.07±0.68)log_(10)IU/mL及免疫耐受組(2.88±0.82)log_(10)IU/mL。HBeAg陽(yáng)性及陰性肝硬化患者抗-HBc分別為(3.04±0.82)、(3.15±0.86)log_(10)IU/mL。HBeAg陽(yáng)性CHB組抗-HBc與ALT(r=0.353,P=0.032)及AST(r=0.421,P=0.009)呈正相關(guān);HBeAg陰性CHB組抗-HBc與HBV DNA(r=0.343,P=0.028)、ALT(r=0.458,P=0.003)及AST(r=0.495,P=0.001)呈正相關(guān)�？�-HBc區(qū)別診斷免疫耐受狀態(tài)及HBeAg陽(yáng)性CHB的AUC為0.903,區(qū)別非活動(dòng)攜帶狀態(tài)及HBeAg陰性CHB的AUC為0.833。結(jié)論不同慢性HBV感染自然史狀態(tài)下血清抗-HBc水平存在明顯差異,且抗-HBc可用于慢性HBV感染自然史狀態(tài)的區(qū)別診斷,診斷價(jià)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 浣庝負(fù):HBeAg闃蟲(chóng)，

本文編號(hào)：1581895