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目的探讨不同类型慢性乙型肝炎(CHB)患者血清病毒水平。方法按2000年西安第十次全国病毒性肝炎及肝病学术会议修订的诊断标准随机选择2003年6月至2007年8月我院的门诊和住院患者378例,分I组52例、Ⅱ组78例、Ⅲ组72例、Ⅳ组54例、V组31例、Ⅵ组71例。进行了HBsAg,抗-HBs,HBeAg,抗-HBe,抗-HBc,抗-HAV-IgM,抗-HCV,抗-HDV,抗-HEV-IgM病毒标记物的血清学和HBV DNA检测。结果①Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ、Ⅵ组HBV DNA阳性率分别为63.46%、60.26%、59.72%、53.70%、61.29%、46.48%。②HBV DNA定量分别为6.58±1.74、6.61±1.53、5.98±1.89、4.94±1.67、4.22±1.11、4.14±0.78。③I组与Ⅱ组HBV DNA定量比较无显著差异(P>0.05);V与Ⅵ组HBV DNA定量比较有显著差异(P<0.05);其余各组HBV DNA定量比较有十分显著差异(P<0.01);④6组CHB患者血清HBsAg(S/N)值检测结果各组比较有显著差异(P<0.05)。结论各型CHB均能检出血清HBV DNA,都有病毒复制,其中ASC和CHB轻度的血清HBV DNA水平较高,与ASC和CHB轻度多处于免疫耐受的高复制有关,而慢性重型和肝炎肝硬化患者的血清HBV DNA水平较低,可能与两者多有病毒变异有关。
Objective To investigate the serum levels of hepatitis B virus in patients with different types of chronic hepatitis B (CHB). Methods A total of 378 outpatients and inpatients in our hospital from June 2003 to August 2007 were randomly selected according to the diagnostic criteria revised by the Tenth National Syndromic Hepatitis and Liver Disease Symposium in Xi’an in 2000. There were 52 cases in group I and 78 cases in group II For example, there were 72 cases in group Ⅲ, 54 cases in group Ⅳ, 31 cases in group V and 71 cases in group Ⅵ. Serological and HBV DNA detection of HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBc, anti-HAV-IgM, anti-HCV, anti-HDV, anti-HEV-IgM viral markers was performed. Results ① The positive rates of HBV DNA in groups Ⅰ, Ⅱ, Ⅲ, Ⅳ, Ⅴ and Ⅵ were 63.46%, 60.26%, 59.72%, 53.70%, 61.29% and 46.48% respectively. ② HBV DNA quantitation were 6.58 ± 1.74, 6.61 ± 1.53, 5.98 ± 1.89, 4.94 ± 1.67, 4.22 ± 1.11, 4.14 ± 0.78, respectively. (3) There was no significant difference in the quantitative HBV DNA between group I and group II (P> 0.05), while the level of HBV DNA in group V and group VI was significantly different (P <0.05) ); ④ The results of serum HBsAg (S / N) in 6 CHB patients showed significant difference (P <0.05). Conclusions Serum HBV DNA can be detected in all kinds of CHB, and all have virus replication. The slight serum HBV DNA level of ASC and CHB is higher, which is associated with the mild hyperplasia of ASC and CHB in immune tolerance, while the chronic heavy type Hepatitis cirrhosis patients with lower levels of serum HBV DNA may be related to both the virus mutation.