The correlations between HBV quantity in the liver tissue and the severity of liver tissue injury in chronic hepatitis B and hepatic cirrhosis
-
摘要: 目的了解慢性乙型肝炎(CHB)、肝硬化患者肝内HBV载量的变化与肝组织损伤程度的关系及其对该类患者的预后意义。方法经血清学及肝穿刺病理组织学证实为CHB 46例,经血清学及影像学确诊、手术获得的肝硬化标本17例。采用实时荧光载量系统检测血清及肝组织HBV DNA载量,并观察肝组织炎症及纤维化程度。结果 (1)肝硬化组血清HBV DNA载量低于HBeAg阳性CHB组(P<0.01)、高于HBeAg阴性CHB组(P<0.001);肝硬化组肝组织HBV DNA载量低于HBeAg阳性及HBeAg阴性CHB组(P<0.001、P<0.01);HBeAg阳性及阴性CHB组的肝组织HBV DNA载量均高于血清HBV DNA载量(P<0.05、P<0.01),肝硬化组肝组织HBV DNA载量低于血清(P<0.001)。(2)CHB、肝硬化血清HBV DNA载量与肝组织的炎症及纤维化程度呈正相关(P<0.05),肝组织HBV DNA载量则与肝组织的炎症及纤维化程度呈明显负相关(P<0.05)。结论肝组织HBV DNA较血清HBV DNA载量更能准确反...Abstract: Objective To understand the correlations between HBV quantity in the liver tissue and severity of hepatic injury in chronic hepatitis B and hepatic cirrhosis.Methods This study included 46 CHB patients and 17 hepatic cirrhosis patients and they were divided into two groups according to HBeAg positive and HBeAg negative.Specimens of all the patients were obtained by liver biopsy or surgery and histology examinations were performed.Intrahepatic HBV DNA and serum HBV DNA quantity were detected by Realtime-PCR.Results (1) Serum HBV DNA quantity of liver cirrhosis group was lower than that of HBeAg (+) CHB group (P<0.01) , but higher than that of HBeAg (-) CHB group (P<0.001) .Intrahepatic HBV DNA quantity of liver cirrhosis group was lower than that of HBeAg (+) and HBeAg (-) CHB groups (P<0.001 and P<0.01 respectively) .Intrahepatic HBV DNA quantity was higher than that of serum HBV DNA in both CHB groups (P<0.05 and P<0.01 respectively) , while intrahepatic HBV DNA quantity was lower than that of the serum HBV DNA in the liver cirrhosis group (P<0.001) . (2) Serum HBV DNA quantity was positively related to hepatic inflammation degree and fibrosis stage (P<0.05) , while intrahepatic HBV DNA quantity was negatively related to hepatic inflammation grade and fibrosis stage (P<0.05) .Conclusion Comparing with serum HBV DNA, intrahepatic HBV DNA quantity can reflect much accurately on HBV amplification in the liver, severity of tissue injury and hepatology progression.
-
Key words:
- hepatitis B /
- chronic /
- liver cirrhosis /
- hepatitis B virus
-
[1]杨瑗, 成军, 黄燕萍, 等.抗乙型肝炎病毒治疗中病毒载量的动力学特点[J].世界华人消化杂志.2004, 12 (7) :1688-1691. [2]李文清, 陈玉丽, 林经安, 等.乙型肝炎病毒血清DNA载量检测的临床意义[J].临床荟萃.2003, 18 (18) :1025-1027. [3] 中华医学会.慢性乙型肝炎防治指南[J].胃肠病学, 2006, 11 (9) :550-556. [4]吕卉, 马立宪, 徐皖苏, 等.载量检测慢性乙型肝炎患者肝组织乙型肝炎病毒DNA的临床价值[J].中华肝脏病杂志, 2003, 11 (3) :173-175. [5]中华医学会.病毒性肝炎防冶方案[J].中华肝脏病杂志, 2000, 8 (3) :324-329. [6]Yu MW, Yeh SH, Chen PJ, et al.Hepatitis B virus genotype and DNA level and hepatocellular carcinoma:a prospective study in men[J].J Natl Cancer Inst, 2005, 97 (4) :265-272. [7]Kumar M, Sarin SK, Hissar S, et al.Virologic and histologic features of chronic hepatitis B virus-infected asymptomatic patients with persistently normal ALT[J].Gastroenterology, 2008, 134 (5) :1376-1384. [8]Ghodrate MD, Maryam R, Mehdi M, et al.Liver histology and HBV DNA levels in chronically HBV infected patients with persistently normal alanine aminotransferase[J].Arch Iran Med, 2010, 13 (3) :193-202. [9]HAN KH, Hollinger FB, Noonan CA, et al.Southern Blot analysis and simultaneous in situ detection of hepatitis B virus associated DNA and antigens in patients with end-stage liver disease[J].Hepatology, 1993, 18 (5) :1032. [10]臧红, 陈国凤, 纪冬, 等.乙型肝炎肝硬化患者HBV血清学模式与病毒载量关系的研究[J].传染病信息, 2008, 21 (2) :97-99. [11]石铭, 王永安, 韩博, 等.慢性乙型肝炎患者肝组织损害程度与肝内HBV DNA关系的研究[J].国外医学临床生物化学与检验分册, 2005, 26 (9) :651-653. [12]Fan JG, Farrell GC.Epidemiology of non-alcoholic fatty liver dusease in China[J].J Hepatol, 2009, 50 (1) :204-210. [13]秦恩强, 赵鹏, 张新伟, 等.血清ALT持续正常及HBeAg阴性慢性HBV感染者86例肝脏病理特征分析[J].临床内科杂志, 2009, 26 (4) :251-253.
本文二维码
计量
- 文章访问数: 4372
- HTML全文浏览量: 13
- PDF下载量: 967
- 被引次数: 0