摘要
目的探讨不同基因类型的慢性乙型肝炎(CHB)患者丙氨酸氨基转移酶(ALT)水平、HBV-DNA载量与肝组织病理损害程度的关系。方法 96例CHB患者行1秒钟快速肝脏穿刺活检术,做肝脏炎症及纤维化评分,而后荧光定量PCR仪检测患者血清HBV-DNA载量,并以限制性片段长度多态性(RFLP)方法进行HBV基因分型。结果 HBV基因类型与CHB患者的性别、年龄无关;C基因型患者HBeAg阳性率明显低于B基因型患者(P<0.05);患者肝组织病理损害程度与感染HBV的基因类型相关,C基因型肝组织炎症及纤维化程度较重组所占比例高于B基因组(P<0.05);B基因型组肝组织炎症及纤维化程度与HBV-DNA水平无关,但在C基因型组肝组织炎症及纤维化程度与HBV-DNA水平相关(P<0.05),在ALT>2倍正常值且G2以上、S2以上组,两种基因型患者的HBV-DNA水平差异亦有统计学意义(P<0.05)。结论 C基因型CHB患者肝脏病理改变明显重于B基因型,C基因型组并随着肝组织炎症及纤维化程度加重,HBV-DNA水平呈下降趋势;在ALT>2倍正常值条件下,炎症程度在G2以上、S2以上组C基因型患者的HBV-DNA水平明显低于B基因型。HBV基因分型检测结合肝穿刺病理检查有助于判断CHB患者疾病病情的轻重,对指导临床治疗及预后评估亦具有借鉴意义。
[Objective] To investigate the relationship between in the ALT level, HBV-DNA level and histopathological damaged in different genotypes chronic hepatitis B （CHB） patients. Methods To evaluate the hepatitis and live fibrosis, then fluorescence quantitative polymerase chain reaction （PCR） instrument is used to test HBV DNA and restriction fragment length polymorphism （RFLP） method is used to test genotypes in 96 cases of patients with CHB done liver biopsy. [Results] HBV genotype was not relationship with CHB patient＇s sex and ages. C genotype was obviously lower than B genotype in hepatitis e antigen （HBeAg） posi- tive patients （P 〈0.05）. The level of histopathological damaged was related with genotypes in hepatitis B virus, the proportion of C genotype in heavier liver tissue inflammation and fibrosis degree was higher than B genotype （P 〈0.05）, the proportion of B genotype in heavier liver tissue inflammation and fibrosis degree was not related with the level of HBV-DNA.However, the proportion of C genotype in heavier liver tissue inflammation and fibrosis degree was related with the level of HBV-NDA （P 〈0.05）. At the condition of ALT〉2 times, over G2 and $2 group, the level HBV-DNA was obviously statistical difference in two genotypes （P〈0.05）. [Con- elusions] The liver tissue histopathological change was higher in C genotype than in B genotype, the tissue inflammation and fibrosis degree was gradually increased in C genotype group, and the level of HBV-DNA was decreased. At the condition of ALT〉2 times, the level of inflammation was over G2 and $2, the level of HBV-DNA was obviously lower in C genotype than in B genotype. Testing genotyping combined with CHB done liver biopsy, which was significantly helped to judge the degree of CHB, and to direct to clinical treat- ment and prognostic estimate.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2014年第23期41-46,共6页
China Journal of Modern Medicine
基金
广西壮族自治区卫生厅2013年科研立项课题(No:Z2013439)
