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目的深入分析慢性乙型肝炎患者血清、唾液乙肝病毒脱氧核糖核酸(HBV-DNA)含量与肝组织及血清纤维化程度间关系的结果,探讨有关因素的临床意义。方法采用荧光聚合酶链反应(FQ-PCR)精确定量配对检测200例慢性乙型肝炎患者血清、唾液中HBV-DNA含量;按肝组织纤维化程度(S)进行病理分级为0-4级,用放射免疫分析法(RIA)测定患者血清、唾液中层黏蛋白(LN)、透明质酸酶(HA)、IV型胶原(IVC)、前Ⅲ型胶原(PCⅢ)的含量。结果血清、唾液HBV-DNA含量与肝组织纤维化程度均无显著相关性(r=0.09,P=0.22;r=0.05,P=0.52);血清、唾液HBV-DNA含量变化与肝纤维化LN、HA、IVC、PCⅢ指标之间结果分析亦均无明显关系(P均>0.05)。结论HBV-DNA含量与肝组织及血清纤维化程度间无明显相关,其可能原因为:①复杂的病理免疫及发病机制;②病理分级方法学差异;③评价方法的局限性。了解这些因素的存在,能够帮助诊断及选择合理治疗。
Objective To analyze in depth the relationship between serum HBV-DNA and salivary hepatitis B virus (HBV-DNA) levels and the degree of liver fibrosis in patients with chronic hepatitis B and to explore the clinical significance of these factors. Methods The levels of HBV-DNA in sera and saliva of 200 patients with chronic hepatitis B were detected by fluorescence quantitative polymerase chain reaction (FQ-PCR). The pathological grade of the patients was grade 0-4 according to the degree of liver fibrosis (S) Serum and salivary mucin (LN), hyaluronidase (HA), type IV collagen (IVC), and type III collagen (PCIII) were measured by radioimmunoassay (RIA). Results Serum and saliva levels of HBV-DNA had no significant correlation with liver fibrosis (r = 0.09, P = 0.22; r = 0.05, P = 0.52) , HA, IVC, PC Ⅲ index between the results of the analysis also had no significant relationship (P all> 0.05). Conclusion There is no significant correlation between HBV-DNA level and the degree of liver fibrosis and liver fibrosis. The possible reasons are: (1) complicated pathological immunity and pathogenesis; (2) pathological grading methodological differences; (3) limitations of evaluation methods. Understanding the existence of these factors can help diagnose and select a reasonable treatment.