HBsAg及HBV DNA定量与HBV相关肝病的诊断

摘要/Abstract

摘要： 目的探讨HBsAg 及HBV DNA定量与HBV相关肝病临床诊断的关系。方法回顾性分析2021年1月至2022年12月在盐城市第一人民医院感染性疾病科初治的HBV感染患者314例,按临床诊断分为慢性乙型肝炎(CHB)组(A组、141例)、乙型肝炎肝硬化代偿期组(B组、48例)、乙型肝炎肝硬化失代偿期组(C组、81例)、HBV相关肝癌组(D组、44例)四组。回顾性分析患者的临床与HBsAg、HBeAg、HBV DNA定量资料。结果 HBeAg阳性者,血清HBsAg 定量[(998.7±944.2)IU/mL]与HBV DNA 定量[(5.4±2.1)lg IU/mL]之间呈正相关(r=0.294,P<0.001)。HBeAg 阴性者,血清HBsAg 定量[(556.7±718.1)IU/mL]与HBV DNA 定量[(3.9±1.9)lg IU/mL]之间呈正相关(r=0.173,P=0.035)。HBeAg 阳性者HBsAg、HBV DNA 水平较HBeAg阴性者高,差异有统计学意义(P<0.05)。HBeAg阳性者,HBsAg定量[(1568.3±990.4)、(513.4±402.3)、(380.6±332.4)、(345.1±254.8)IU/mL]、HBV DNA定量水平[(6.0±2.3)、(5.3±1.6)、(4.6±1.7)、(4.5 ±1.7)lg IU/mL]在A、B、C、D四组中呈递减趋势(K-W检验显示渐进显著性,P<0.05)。HBeAg阴性者,HBsAg[(855.9±119.3)、(497.9±625.0)、(329.1±452.0)、(305.1±407.4)IU/mL]定量水平在A、B、C、D四组中呈递减趋势(K-W检验显示渐进显著性,P<0.05),HBV DNA 定量[(4.3±2.0)、(3.5±1.8)、(3.6±1.6)、(3.8 ±1.7)lg IU/mL]在四组间无明显差异,相关性不明显(K-W 检验显示无差异,P=0.242)。结论 HBsAg定量与HBV DNA定量呈显著正相关,且随肝病的严重程度呈进行性下降;但当HBeAg阴性时,HBV DNA定量与肝病严重程度之间相关性不明显。

关键词: 乙型肝炎表面抗原, 乙型肝炎病毒脱氧核糖核酸, 慢性乙型肝炎, 诊断

Abstract: Objective To investigate the relationship of HBsAg and HBV DNA quantification and diagnosis of HBV-related liver diseases.Methods A total of 314 patients with HBsAg infection primary treated in the department of infection of the First People's Hospital of Yancheng from January 2021 to December 2022 were retrospectively analyzed. According to the clinical diagnosis, they were divided into four groups: chronic hepatitis B (CHB) group (group A, 141 cases), compensated hepatitis B cirrhosis group (group B, 48 cases), decompensated hepatitis B cirrhosis group (group C, 81 cases) and HBV-related liver cancer group (group D, 44 cases).The clinical and quantitative data of HBsAg, HBeAg and HBV DNA were analyzed retrospectively.Results In HBeAg-positive patients, there was a positive correlation between serum HBsAg quantification [(998.7± 944.2) IU/mL] and HBV DNA quantification [(5.4±2.1) lg IU/m] (r=0.294, P<0.001). In HBeAg-negative patients, there was a positive correlation between serum HBsAg quantification [(556.7±718.1)IU/mL] and HBV DNA quantification [(3.9±1.9) lg IU/mL] (r=0.173, P=0.035).The levels of HBsAg and HBV DNA in HBeAg positive patients were higher than those in HBeAg negative patients, and the difference was significant (P<0.05). In HBeAg positive patients, the quantitative levels of HBsAg [(1568.3±990.4、513.4±402.3、380.6±332.4、345.1±254.8)IU/mL]and HBV DNA[(6.0±2.3、5.3±1.6、4.6±1.7、4.5 ±1.7)lg IU/mL] showed a decreasing trend in groups A, B, C and D ( Kruskal-Wallis test showed progressive significance, P<0.05). In HBeAg-negative patients, the quantitative level of HBsAg[(855.9±119.3、497.9±625.0、329.1±452.0、305.1±407.4)IU/mL] in group A, B, C and D showed a decreasing trend (Kruskal-Wallis test showed gradual significance, P<0.05), and there was no significant difference in HBV DNA quantification [(4.3±2.0、3.5±1.8、3.6±1.6、3.8 ±1.7)lgIU/mL]among the four groups, and the correlation was not obvious (Kruskal-Wallis test showed no difference, P=0.242).Conclusion There is a significant positive correlation between HBsAg quantification and HBV DNA quantification, and gradually decreases with the severity of liver disease; while HBeAg is negative, there is no obvious correlation between HBV DNA quantification and the severity of liver disease.

Key words: Hepatitis B surface antigen, Hepatitis B virus deoxyribonucleic acid, Chronic hepatitis B, Diagnosis

薛荣荣, 蔡炳冈, 咸建春. HBsAg及HBV DNA定量与HBV相关肝病的诊断[J]. 肝脏, 2023, 28(12): 1462-1465.

XUE Rong-rong, CAI Bing-gang, XIAN Jian-chun. HBsAg and HBV DNA quantification and diagnosis of HBV-related liver diseases[J]. Chinese Hepatolgy, 2023, 28(12): 1462-1465.

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