發(fā)布時間：2018-04-29 21:33

  本文選題：HBV + DNA�。� 參考：《鄭州大學(xué)》2015年碩士論文

【摘要】：目的：探索利用血清HBV DNA水平及肝臟彈性測量值(LSM)在預(yù)測HBeAg陰性慢性乙型肝炎患者肝纖維化程度中的意義。方法對175例HBeAg陰性慢性乙型肝炎患者行肝臟穿刺病理組織學(xué)檢查、血清HBV DNA水平檢測和肝臟彈性值測定,根據(jù)肝臟病理改變,將其纖維化程度分為SO-S4,將S0-S1定義為A組,S2為B組,S3為C組,S4為D組,S0-S1為非顯著性肝纖維化,S2-S4為顯著性肝纖維化。結(jié)果在175例e抗原陰性慢性乙型肝炎患者中,71(41%)例患者無明顯肝臟纖維化(S0-S1),94(59%)例患者有顯著的肝纖維化(S≥2)。LSM及HBV DNA隨著肝纖維化病理分期的增加而增大。采用單因素方差分析比較各組間LSM的均數(shù),差異具有統(tǒng)計學(xué)意義(F=120.10,P值0.05),相鄰兩組間LSM均值差異均具有統(tǒng)計學(xué)意義(Z值在-3.578～-2.520之間,P值均0.05)。血清HBVDNA載量在A組與B、C、D組之間的差異具有統(tǒng)計學(xué)意義(P均0.05)。利用受試者工作特征曲線下面積(AUROC)分析：LSM、血清HBV DNA診斷肝組織纖維化程度的AUROC分別為0.8、0.7,均顯著大于診斷參考線下面積(P均0.05),95%的置信區(qū)間(CI)分別為0.642-0.874、0.632-0.769。HBeAg陰性的CHB患者,以血清HBV DNA≥6.053×105IU/ml為界值,其診斷肝臟纖維化程度的靈敏度0.627、準(zhǔn)確度分別為0.689、特異度為0.658；以LSM≥8.5kpa為界值,診斷顯著纖維化的靈敏度、特異度、準(zhǔn)確度分別為0.752、0.895和0.732。結(jié)論HBeAg陰性慢性乙型肝炎患者中,血清HBV DNA與肝臟彈性測量值均能預(yù)測顯著肝纖維化,肝臟彈性測量值價值更大。
[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，

本文編號：1821643