摘要
目的分析不同年龄段慢性乙型肝炎(chronic B virus,CHB)患者乙型肝炎病毒血清标志物(hepatitis B-M,HBVM)、前S1抗原(Pre S1)和乙型肝炎病毒DNA(hepatitis B virus-DNA,HBV-DNA)与肝纤维化的相关性。方法选取2020年1月至2022年8月安徽省六安市中医院收治的200例CHB患者,根据HBV-M[乙型肝炎病毒表面抗原(hepatitis B virus surface antigen,HBs Ag)、抗乙型肝炎病毒表面抗原抗体(antibody to hepatitis surface antigen,HBs Ab)、乙型肝炎病毒e抗原(hepatitis B virus e antigen,HBe Ag)、抗乙型肝炎病毒e抗原抗体(antibody to hepatitis B e-antigen,HBe Ab)、抗乙型肝炎病毒核心抗体(antibody to hepatitis B core antigen,HBc Ab)分别用a、b、c、d、e表示]检测结果分组,分析各组Pre S1定量与阳性率、HBV-DNA载量与阳性率在不同年龄段(<40岁、40~60岁、>60岁)中的差异,比较不同临床参数下的PreS1和HBV-DNA、肝纤维化指标[Ⅲ型前胶原氨基末端肽(procollagen typeⅢ,PCⅢ)、Ⅳ型胶原(Ⅳcollagen,Ⅳ-C)],分析肝纤维化指标与HBV-DNA、Pre S1的相关性。结果不同年龄段患者HBV-M、PreS1、HBV-DNA、PCⅢ、Ⅳ-C水平差异有显著性(P<0.05),年龄<40岁患者的HBeAg阳性率、HBe Ab阳性率、Pre S1定量与阳性率、HBV-DNA载量与阳性率最高,分别为33.3%、63.9%、(25.6±2.6)S/CO、81.9%、(3.2±0.4)log 10U/ml、77.8%(P<0.05),而PCⅢ定量与阳性率、Ⅳ-C定量与阳性率最低,分别为(110.4±12.3)μg/ml、12.5%、(109.4±10.5)μg/L、13.8%(P<0.05);在a+c+e阳性患者中,不同年龄段的PreS1阳性率差异有显著性(P<0.05),在a+c+e阳性及a+d+e阳性患者中,不同年龄段的HBV-DNA阳性率差异有显著性(P<0.05);伴肝硬化患者PreS1、HBV-DNA、PCⅢ、Ⅳ-C阳性率分别为75.0%、80.2%、38.5%、33.3%,均显著高于不伴肝硬化的患者(60.6%、39.4%、16.3%、10.6%)(P<0.05);PCⅢ阳性率、Ⅳ-C阳性率与Pre S1定量、HBV-DNA载量呈正相关(P<0.05),年龄与Pre S1定量、HBV-DNA载量呈负相关,而Pre S1定
Objective The purpose of this study was to analyze the changes and clinical significance of five serum markers of hepatitis B(HBV-M),pre-S1 antigen(preS1),HBV-DNA and liver fibrosis in chronic hepatitis B(CHB)patients of different age groups.Method 200 patients with CHB were admitted to Lu’an Hospital of Traditional Chinese Medicine between January 2020 and August 2022.The subjects were divided into 3 age groups.Then,they were grouped according to HBV-M(HBsAg,HBsAb,HBeAg,HBeAb and HBcAb represented with a,b,c,d and e,respectively)testing results.The differences in the quantification and positive rate of PreS1,HBVDNA load and positive rate among different age groups were analyzed.The preS1 antigen,HBV-DNA and liver fibrosis indexes[typeⅢprocollagen(PCⅢ)and type IV collagen(Ⅲ-C)]under different clinical parameters were compared.The correlation of liver fibrosis indexes with HBV-DNA and preS1 was analyzed.Result HBV-M,preS1,HBV-DNA,PCⅢandⅢ-C were different in different age groups(P<0.05).The HBeAg positive rate,HBeAb positive rate,preS1 quantification and positive rate,HBV-DNA load and positive rate were the highest in patients under 40 years old,which were 33.3%,63.9%,(25.6±2.6)S/CO,81.9%,(3.2±0.4)log 10U/ml and 77.8%(P<0.05).PCⅢquantification and positive rate,Ⅲ-C quantification and positive rate were the lowest in patients under 40 years old,which were(110.4±12.3)μg/ml,12.5%,(109.4±10.5)μg/L and 13.8%(P<0.05).In a+c+e-positive patients,preS1 positive rates in different age groups were different(P<0.05).In a+c+e-positive and a+d+e-positive patients,HBV-DNA positive rates in different age groups were different(P<0.05).The positive rates of preS1 antigen,HBV-DNA,PCⅢandⅢ-C in patients complicated with liver cirrhosis were 75.0%,80.2%,38.5%and 33.3%,significantly higher than those in patients without liver cirrhosis(60.6%,39.4%,16.3%and 10.6%,P<0.05).The positive rates of PCⅢandⅢ-C were positively correlated with PreS1 quantification and HBV-DNA load(P<0.05).Age was negatively correlated
作者
何伟
田水林
施卫兵
He Wei;Tian Shuilin;Shi Weibing(Department of Hepatology,Lu’an Hospital of Traditional Chinese Medicine,Anhui Lu’an 237006,China;Department of Infectious Diseases and Hepatology,First Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Anhui Hefei 230009,China)
出处
《中国医刊》
CAS
2023年第12期1307-1312,共6页
Chinese Journal of Medicine
基金
十三五国家科技重大专项课题(2018ZX10725-504)。
