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目的探讨血液淋巴细胞计数(BLC)、HBV-DNA载量、血清总胆醇(STC)在预示重型肝炎趋势,诊断早期重型肝炎及判断预后中的价值。方法选择初诊慢性乙型肝炎(中度)84例,按最终演变情况,分为慢性乙肝(重度)组和重型肝炎组,观察两组BLC、HBV-DNA载量和STC的变化情况,并对重肝患者持续追踪检测STC。结果与重度组比较,重型组的BLC和STC的异常率较高(P<0.005和P<0.05),而BLC和STC的均值较低(P<0.0005和P<0.05)。重度组的HBV-DNA载量始终较高,在5.6×105~3.1×108copies/ml,而重型组的HBV-DNA载量,则显著降低,有20例阴性,其余12例在1.1~8.2×103copies/ml。重型肝炎患者存活组与死亡组的STC水平存在非常显著性差异(P<0.0005)。有10例重肝患者PTA>40%,其中7例STC<2.6mmol/L,6例死亡。结论BLC、HBV-DNA载量和STC有助于预测慢性乙肝(中度)的发展趋势,对早期诊断重型肝炎和判断预后有重要价值。
Objective To investigate the value of blood lymphocyte count (BLC), HBV DNA load and serum total cholesterol (STC) in predicting the trend of severe hepatitis, diagnosing early severe hepatitis and prognosis. Methods Eighty-four patients with newly diagnosed chronic hepatitis B (moderate) were enrolled. According to the final changes, the patients were divided into chronic hepatitis B (severe) group and severe hepatitis group. The changes of BLC, HBV-DNA load and STC in both groups were observed. Patients with severe liver follow-up testing STC. Results Compared with the severe group, the abnormal rates of BLC and STC in severe group were higher (P <0.005 and P <0.05), while those in BLC and STC were lower (P <0.0005 and P <0.05). In the severe group, the HBV-DNA load was always higher at 5.6 × 105 ~ 3.1 × 108copies / ml, whereas in the severe group, the HBV-DNA load was significantly lower, with 20 negative and the remaining 12 at 1.1 ~ 8.2 × 103copies / ml. There was a very significant difference in STC levels between survivors and deaths in patients with severe hepatitis (P <0.0005). There were 10 patients with severe liver PTA> 40%, of which 7 cases of STC <2.6mmol / L, 6 patients died. Conclusions BLC, HBV DNA load and STC are helpful to predict the development of chronic hepatitis B (moderate) and have important value in early diagnosis of severe hepatitis and prognosis.