探讨HBV-DNA和AFP血清浓度的变化与HBV感染者转归的关系

摘要

目的：探讨乙肝病毒感染者血清中HBV-DNA拷贝数与AFP浓度的变化对其转归的影响。方法收集2012年1月-2013年1月来该院就诊的400例乙肝病毒感染者血清,参照乙型肝炎和原发性肝癌的诊断标准进行如下分组：慢性乙型肝炎组200例,肝炎肝硬化组150例,肝癌组50例。对收集的标本采用实时荧光定量的方法检测出HBV-DNA水平,化学发光法检测AFP的浓度,然后对结果进行统计分析。结果在所有病例中,慢性乙型肝炎组HBV-DNA拷贝数为(5.38±1.66),在3组中最高,而肝癌组HBV-DNA拷贝数为(4.41±1.43)在3组中最低。慢性乙型肝炎组与其他两组比较,P<0.01,差异有统计学意义；3组间AFP浓度的变化进行比较,差异有统计学意义(P<0.05)。3组中HBV-DNA拷贝数及AFP浓度变化和组别之间有明显的相关性,其中HBV-DNA的变化与病程呈反相关,而AFP的变化则呈正相关。结论乙肝病毒感染者应定期定量检测血清中HBV-DNA的含量,判断病毒的复制情况,并同时检测AFP浓度,以期尽早发现肝组织的损害程度及病情的演变过程,对乙肝病毒感染者病程转归的监测和预后判断具有重要的意义。%Objective To investigate the effect of variations of HBV-DNA copy number and alpha fetal protein (AFP) concentra-tion in serum on the turnover of hepatitis B patients. Methods The serum of 400 hepatitis B patients visited our hospital from Jan-uary 2012 to January 2013 were collected. According to the diagnostic standard of hepatitis B and hepatocellular carcinoma(HCC), the patients were divided into chronic hepatitis B group of 200 cases, liver cirrhosis group of 150 cases, HCC group of 50 cases. Fluorescent quantitation was used to detect the levels of HBV-DNA, and chemiluminescence method was adopted to measure the levels of AFP. And the results were analyzed statistically. Results Of all the patients, the HBV-DNA copy number of chronic hep-atitis B group was 5.38±1.66, which was the highest in the 3 groups, while that of the HCC group (4.41±1.43) was the lowest. There were statistically significant differences between chronic hepatitis B group, liver cirrhosis group and HCC group in the levels of HBV-DNA, P<0.01; analogously, there were statistically significant differences between these three groups in the changes of serum AFP concentration, P<0.05. HBV-DNA copy numbers and diversity of AFP density correlate with different arrays in these three groups. The changes of HBV-DNA were negatively correlated with the disease, while those of AFP were positively correlated with the disease. Conclusion It is suggested that patients with hepatitis B virus infection should measure the concentration of HBV-DNA and AFP concentration regularly and quantitatively in serum for judging the virus replication and identifying the extent of damage of liver tissue and the progression of the disease as early as possible, which is of great significance in monitoring the course of disease turnover and evaluating the prognosis of the patients.