本文選題：乙肝表面抗原定量(HBsAg) + 慢性HBV感染　； 參考：《浙江大學(xué)》2014年碩士論文

【摘要】：背景與目的：乙型肝炎病毒表面抗原(HBsAg)是感染乙肝病毒(HBV)的早期標(biāo)記物,HBsAg定性檢測作為篩選工具已經(jīng)沿用幾十年。近年來,HBsAg定量在慢性乙型肝炎病毒(HBV)感染狀態(tài)評估及預(yù)測抗病毒療效等方面得到了越來越多的關(guān)注。本研究的目的是確定浙江省的慢性HBV感染各個(gè)階段HBsAg水平。 方法：本研究納入浙江大學(xué)附屬第一醫(yī)院從2012年2月至2013年2月期間門診及住院共623名患者。根據(jù)((2012年歐洲肝臟研究協(xié)會(huì)(EASL)臨床實(shí)踐指南》、《亞太地區(qū)慢性乙型肝炎臨床實(shí)踐指南》和((2010版中國慢性乙型肝炎的臨床實(shí)踐指南》診斷標(biāo)準(zhǔn),將患者分為免疫耐受期(IT,n=108),免疫清除期(IC,n=161),HBeAg陰性肝炎期(ENH, n=149),低復(fù)制期(LR,n=135)和肝硬化期(LC,n=70),對其相關(guān)參數(shù)進(jìn)行分析,即乙肝表面抗原定量(雅培ARCHITECT測定法)和HBV-DNA相關(guān)性,及與血清ALT/AST在慢性乙型肝炎(CHB)的各個(gè)階段的相關(guān)性進(jìn)行統(tǒng)計(jì)學(xué)分析。 結(jié)果：CHB的每個(gè)階段HBsAg中位值之間存在差異(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與乙肝HBV-DNA相關(guān)性最強(qiáng)的是在免疫清除期(r=0.683,P0.001)。同時(shí)觀察到HBsAg水平和ALT/AST之間沒有相關(guān)性。 結(jié)論本研究結(jié)論(1)HBsAg滴度HBV感染的五個(gè)階段不同；(2) HBsAg水平在IT期最高在LC最低；(3)在IC期,HBsAg水平與HBVDNA有很強(qiáng)的相關(guān)性；(4)基因B型和C型之間的所有五個(gè)階段的HBsAg中位數(shù)水平?jīng)]有明顯差異。
[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.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R512.62

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本文編號：1995068