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目的观察人工肝技术和肝移植手术对重症乙肝患者乙肝病毒标志物的影响。方法乙肝三系统定量采用时间分辨免疫荧光技术,乙肝病毒DNA定量采用实时荧光定量PCR法。结果28例实施人工肝技术的重型肝炎患者治疗前后的乙肝三系统定量和HBV DNA定量结果为:HBsAg171.19±32.10 ng/mL,HBeAg 0.03±0.029 NCU/mL,抗-HBe 3.97±4.61 NCU/mL,抗-HBc 5.98±3.31 NCU/mL,HBV DNA(1.1×10~7)±(6.81×10~6)copy/mL和HBsAg 168.14±39.40 ng/mL,HBeAg 0.02±0.023 NCU/mL,抗-HBe 3.95±4.34 NCU/mL,抗-HBc 6.41±3.13 NCU/mL,HBVDNA(1.1×10~7)±(6.23×10~6)copy/mL。P值均大于0.05,差异无统计学意义。26例施行肝移植手术的患者治疗前后的乙肝三系统定量和HBV DNA定量结果分别为HBsAg 144.65±77.00ng/mL,HBeAg 0.02±0.028 NCU/mL,抗-HBe 4.32±6.43 NCU/mL,抗-HBc 6.04±4.88 NCU/mL,HBV DNA(1.0×10~7)±(6.89×10~6)copy/mL和HBsAg 6.54±3.32 ng/mL,HBeAg 0.02±0.016 NCU/mL,抗-HBe 4.79±6.44 NCU/mL,抗-HBc 5.97±4.64 NCU/mL,HBV DNA(1.04×10~2)±(3.40×10~2)copy/mL。除抗-HBe和抗-HBc,P值大于0.05外,其他项目P值均小于0.05,差异有统计学意义。结论肝移植手术可有效清除乙肝患者体内的乙肝病毒,人工肝支持系统虽不能有效清除乙肝患者体内的乙肝病毒,但可改善重型肝炎患者体内严重紊乱的内环境,为肝移植手术创造合适的条件和机会,赢得宝贵时间。
Objective To observe the effect of artificial liver technique and liver transplantation on hepatitis B virus (HBV) markers in patients with severe hepatitis B Methods The three systems of hepatitis B (HBV) were quantified by time-resolved immunofluorescence, and real-time quantitative PCR was used to quantify hepatitis B virus DNA. Results The quantification of HBsAg and HBV DNA before and after treatment in 28 patients with severe hepatitis treated with artificial liver technique were: HBsAg171.19 ± 32.10 ng / mL, HBeAg 0.03 ± 0.029 NCU / mL, anti-HBe 3.97 ± 4.61 NCU / mL, anti-HBc 5.98 ± 3.31 NCU / mL, HBV DNA (1.1 × 10 ~ 7) ± (6.81 × 10 ~ 6) copy / mL and HBsAg 168.14 ± 39.40 ng / mL, HBeAg 0.02 ± 0.023 NCU / mL, -HBe 3.95 ± 4.34 NCU / mL, anti-HBc 6.41 ± 3.13 NCU / mL, HBVDNA (1.1 × 10 ~ 7) ± (6.23 × 10 ~ 6) copy / mL. P values were greater than 0.05, the difference was not statistically significant. Twenty-six patients undergoing liver transplantation before and after treatment had HBV DNA quantification and HBV DNA quantification of 144.65 ± 77.00 ng / mL, HBeAg 0.02 ± 0.028 NCU / mL, anti-HBe 4.32 ± 6.43 NCU / mL, anti- HBc 6.04 ± 4.88 NCU / mL, HBV DNA (1.0 × 10 ~ 7) ± (6.89 × 10 ~ 6) copy / mL and HBsAg 6.54 ± 3.32 ng / mL, HBeAg 0.02 ± 0.016 NCU / mL and anti-HBe 4.79 ± 6.44 NCU / mL, anti-HBc 5.97 ± 4.64 NCU / mL, HBV DNA (1.04 × 10 ~ 2) ± (3.40 × 10 ~ 2) copy / mL. In addition to anti-HBe and anti-HBc, P values greater than 0.05, other items P values ?? were less than 0.05, the difference was statistically significant. Conclusions Liver transplantation can effectively remove hepatitis B virus from hepatitis B patients. Although artificial liver support system can not effectively remove hepatitis B virus from hepatitis B patients, it can improve the internal environment of patients with severe hepatitis and create a suitable condition for liver transplantation And opportunities to win valuable time.