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目的探讨乙型肝炎病毒(HBV)不同感染模式病毒复制情况以及各模式丙氨酸氨基转移酶(Aminotransferase,ALT)含量差异分析。方法采用酶联免疫吸附试验(ELISA)、荧光定量PCR以及自动化生化分析仪速率法对1 021例乙型肝炎病毒感染者进行HBV血清标志物:HBV表面抗原(HBs Ag)、抗HBV表面抗原-抗体(HBs Ab)、HBV e抗原(HBe Ag)、抗HBV e抗原-抗体(HBe Ab)、HBV核心抗体(HBc Ab),HBV-DNA含量以及ALT检测,并对常见三种模式HBV-DNA含量以及ALT进行差异分析,同时依据血清学免疫指标HBe Ag以及病毒复制情况将资料分为四组:HBe Ag(+)HBV-DNA(+)、HBe Ag(+)HBV-DNA(-)、HBe Ag(-)HBV-DNA(+)、HBe Ag(-)HBV-DNA(-),并对该四组资料肝功能差异进行分析。结果此研究发现HBV感染有7种模式,乙型肝炎患者血清中HBV-DNA阳性百分比为45.25%,ALT>40 U/L的人群百分比为20.27%,ALT>120 U/L人群百分比为3.13%;HBe Ag(+)组与HBe Ag(-)两组HBV-DNA阳性百分比差异有统计学意义,两组丙氨酸氨基转移酶异常率差异有统计学意义(P<0.05)。HBe Ag(-)HBV-DNA(-)组ALT>40 U/L的人群百分比以及ALT含量均低于其他三组,差异有统计学意义(P<0.05)。结论HBV血清标志物与HBV-DNA复制情况存在相关性,且与ALT水平密切相关,HBV血清标志物与HBV-DNA能准确地判断HBV复制情况以及其传染性,ALT水平能较好地判断感染人群肝功能情况,三者相结合能给临床的诊断以及疗效观察提供可靠的依据。
Objective To investigate the replication of hepatitis B virus (HBV) in different infection modes and to analyze the differences of the content of ALT between different modes. Methods A total of 1,021 cases of hepatitis B virus infection were assayed for serum HBV markers (HBs Ag), anti-HBV surface antigen- HBs Ab, HBe Ag, HBe Ab, HBc Ab, HBV-DNA content and ALT were detected in all the patients. HBV-DNA (HBe Ag +) HBV-DNA (+), HBeAg (+) HBV-DNA (-) and HBe Ag (+) were also divided into four groups according to the serological immune index HBe Ag and the virus replication. HBe Ag (-) HBV-DNA (+), HBeAg (-) HBV-DNA (-) were detected and their differences in liver function were analyzed. Results There were 7 patterns of HBV infection in this study. The positive percentage of HBV-DNA in serum of patients with hepatitis B was 45.25%, the percentage of people with ALT> 40 U / L was 20.27%, the percentage of people with ALT> 120 U / L was 3.13% The positive percentage of HBV-DNA in HBe Ag (+) group and HBe Ag (-) group were statistically significant, the difference of alanine aminotransferase between the two groups was statistically significant (P <0.05). The percentage of people with ALT> 40 U / L in HBe Ag (-) HBV-DNA (-) group and ALT content were lower than the other three groups (P <0.05). Conclusions HBV serum markers are correlated with HBV-DNA replication and closely related to ALT level. HBV serum markers and HBV-DNA can accurately determine HBV replication and its infectivity, and ALT levels can better determine the infection The liver function of the population, the combination of the three can provide a reliable basis for the clinical diagnosis and efficacy observation.