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目的:评价不同载量的乙型肝炎病毒对乙肝患者血脂水平的影响。方法:采用全自动生化分析仪检测412例慢性乙型肝炎患者的肝功、肾功、血脂、血糖等指标,采用荧光定量PCR检测被测者的病毒载量,采用全自动血凝仪检测血浆凝血酶原活动度(PTA)。结果:协方差分析提示在轻度、中度、重度慢性乙型肝炎组中,不同病毒载量的乙型肝炎病毒对血脂水平[胆固醇(CHOL)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]无影响或影响甚微。在慢性重型肝炎组中,不同载量的乙型肝炎病毒对血脂水平有明显影响。同时多元线性回归分析显示重型肝炎组中血脂水平主要受病毒载量(lgDNA)、PTA、白蛋白(ALB)等的影响。结论:不同载量的乙型肝炎病毒对血脂水平的影响在各个病变阶段是不同的,通过动态观察血脂水平和病毒载量,可以了解机体的免疫状况以及乙型肝炎病毒在机体病理性免疫反应中所发挥的作用。
Objective: To evaluate the effect of different doses of hepatitis B virus (HBV) on the level of blood lipid in hepatitis B patients. Methods: The indexes of liver function, kidney function, blood fat, blood glucose and blood sugar of 412 patients with chronic hepatitis B were detected by automatic biochemical analyzer. The viral load was measured by real-time quantitative PCR. Plasma was measured by automatic blood coagulation analyzer Prothrombin activity (PTA). Results: Covariance analysis suggested that different viral loads of hepatitis B virus had a significant effect on blood lipid levels (cholesterol, triglyceride (TG), high density lipoprotein Cholesterol (HDL-C), Low Density Lipoprotein Cholesterol (LDL-C)] had little or no effect. In the chronic severe hepatitis group, hepatitis B virus of different loading levels had a significant effect on blood lipid levels. At the same time, multiple linear regression analysis showed that the level of serum lipids in severe hepatitis group was mainly affected by the viral load (lgDNA), PTA, albumin (ALB) and so on. Conclusion: The effects of hepatitis B virus at different doses on blood lipid levels are different at different stages of the disease. By dynamically observing the blood lipid level and viral load, we can understand the immune status of the body and the pathological immune response of the hepatitis B virus In the role played.