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目的探讨慢性乙肝患者血清学标志物(HBV-M)与乙型肝炎病毒(HBV)DNA、丙氨酸氨基转移酶(ALT)、甲胎蛋白(AFP)的检测结果及其关系。方法对1 838例慢性乙肝患者采取空腹静脉血,用酶联免疫吸附试验(ELISA)检测HBV-M及AFP,用赖氏法检测ALT,用套式PCR(nPCR)检测血清HBV DNA。结果1 838例慢性乙肝患者HBV DNA阳性率、ALT异常率、AFP阳性率分别为56.75%(1 043/1 838)、13.93%(256/1 838)、2.23%(41/1 838)。HBV-M模式检测中,“大三阳”占14.52%,“小三阳”占76.13%。“大三阳”患者HBV DNA阳性率(96.97%)明显高于“小三阳”患者(47.04%),二者差异有统计学意义(P<0.01);“大三阳”患者ALT异常率、AFP阳性率(22.35%、3.41%)高于“小三阳”患者(11.42%、1.45%),差异均有统计学意义(P均<0.05)。HBV DNA(+)组ALT异常升高率、AFP阳性率(20.04%、3.26%)均明显高于HBV DNA(-)组(5.91%、0.88%),差异均有统计学意义(P均<0.01)。结论联合检测慢性乙肝患者血清HBV DNA、HBV-M、ALT、AFP,对乙型肝炎的临床诊治和预后判断具有重要意义。
Objective To investigate the relationship between HBV-M, hepatitis B virus (HBV) DNA, alanine aminotransferase (ALT) and alpha-fetoprotein (AFP) in chronic hepatitis B patients. Methods Fasting venous blood was collected from 1 388 chronic hepatitis B patients. HBV-M and AFP were detected by enzyme-linked immunosorbent assay (ELISA). ALT was detected by Lai’s method. Serum HBV DNA was detected by nested PCR (nPCR). Results The HBV DNA positive rate, ALT abnormal rate and AFP positive rate of 1 388 patients with chronic hepatitis B were 56.75% (1043/1 838), 13.93% (256/1 838) and 2.23% (41/1 838), respectively. In the detection of HBV-M mode, “Big Three” accounted for 14.52%, “Small Three Positive” accounted for 76.13%. The positive rate of HBV DNA (96.97%) in patients with Sansheng Yang was significantly higher than that in patients with Sansanyang (47.04%), the difference was statistically significant (P <0.01) The abnormal rate of ALT, the positive rate of AFP (22.35%, 3.41%) was higher than that of the patients with small Sanyang (11.42%, 1.45%) (all P <0.05). The positive rate of ALT in HBV DNA (+) group was significantly higher than that in HBV DNA (-) group (20.04%, 3.26%, 5.91%, 0.88%, P < 0.01). Conclusion The combined detection of serum HBV DNA, HBV-M, ALT and AFP in patients with chronic hepatitis B is of great significance for the clinical diagnosis and prognosis of hepatitis B.