血清病毒学标记物预测慢性乙型肝炎肝组织病理状态的评价

目的评价血清病毒学标记物预测慢性乙型肝炎(CHB)肝组织病理状态的有效性。方法 CHB患者211例,其中HBeAg阳性和阴性患者分别为125例和86例。血清HBsAg、HBeAg、抗-HBc和HBcrAg分别采用化学发光微粒子免疫法和化学发光酶免疫法检测,血清HBV DNA采用实时荧光定量PCR检测。结果 HBeAg阳性患者,血清HBsAg、HBeAg、HBcrAg、HBV DNA与病理学分级和分期均呈显著负相关(P＜0.05)；血清抗-HBc与病理学分级和分期均呈显著正相关(P＜0.05)；HBeAg阴性患者,血清HBsAg、抗-HBc与病理学分级和分期无显著相关性(P＞0.05)；血清HBcrAg、HBV DNA与病理学分级和分期均呈显著正相关(P＜0.01)。有序logistic回归分析显示,HBeAg阳性患者,血清HBsAg预测病理学分级和HBsAg、HBeAg预测病理学分期的偏回归系数有统计学意义(P＜0.05)；HBeAg阴性患者,血清HBcrAg和HBV DNA预测病理学分级和分期的偏回归系数均有统计学意义(P＜0.05)。结论 血清HBsAg和血清HBsAg、HBeAg分别有预测HBeAg阳性患者肝组织病理学分级和分期的价值,血清HBcrAg和HBV DNA均有预测HBeAg阴性患者肝组织病理学分级和分期的意义。
Objective To assess the application of serum viral markers in prediction of pathological status of liver tissue in patients with chronic hepatitis B. Methods Two hundred and eleven patients with chronic hepatitis B, including 125 HBeAg-positive and 86 HBeAg-negative patients, were enrolled in present study. Serum HBsAg, HBeAg, anti-HBc and HBcrAg were measured by chemilu-minescence microparticle immunoassay and chemiluminescence enzyme immunoassay, respectively; HBV DNA was assayed by Real Time fluorescent quantitative PCR. ResultsIn HBeAg-positive patients, serum HBsAg, HBeAg, HBcrAg and HBV DNA were significantly correlated negatively with the pathological grading and staging of liver tissue(P＜0.05), and serum anti-HBc was significantly correlated positively with the pathological grading and staging of liver tissue(P＜0.05). in HBeAg-negative patients, serum HBsAg and anti-HBc were not correlated with the pathological grading and staging of liver tissue(P＞0.05), however, serum HBcrAg and HBV DNA were significantly correlated positively with the pathological grading and staging of liver tissue(P＜0.01). Ordinal logistic regression analyses showed that in HBeAg-positive patients the partial regression coefficients of serum HBsAg in predicting the pathological grading and serum HBsAg, HBeAg in predicting the pathological staging of liver tissue had statistical significance(P＜0.05); in HBeAg-negative patients, the partial regression coefficients of serum HBcrAg and HBV DNA in predicting both the pathological grading and staging of liver tissue had statistical significance(P＜0.05). Conclusion Serum HBsAg and HBsAg, HBeAg in HBeAg-positive patients have predictive value to the pathological grading and staging, and serum HBcrAg and HBV DNA in HBeAg-negative patients have predictive significance to the pathological grading and staging of liver tissue