目的：探讨慢性乙型肝炎患者血清不同HBV-DNA载量与炎性因子、肝功能酶学指标的关系。方法对78例慢性乙型肝炎患者分别用实时荧光定量PCR技术检测血清HBV-DNA载量，并以此分为阴性组（17例）、低载量组（30例）、中载量组（19例）、高载量组（12例）4组，比较各组高敏C反应蛋白（ hs-CRP）、肿瘤坏死因子α（ TNF-α）、白介素6（IL-6）、肝功能相关酶（ALT、AST、GGT）的水平，并探讨其相关性。结果随着HBV-DNA载量的增高， TNF-α、IL-6均明显升高，表现为高载量组＞中载量组＞低载量组＞阴性组，组间比较差异有统计学意义（ P ＜0靠．05）。血清hs-CRP中载量组、低载量组间水平比较差异无统计学意义（ P ＞0．05），其余2组间比较差异有统计学意义（P＜0．05）。各组间血清ALT、AST、GGT水平比较，表现为高载量组＞中载量组＞低载量组＞阴性组，组间比较差异有显著统计学意义（ P ＜0．05）。 ALT与TNF-α、IL-6相关（ r ＝0．68、0．56， P ＜0．05）；ALT与hs-CRP无相关性（ r ＝0．23， P ＞0．05）。结论炎性因子在乙肝的发病过程中有重要作用，综合检测血清炎性因子和肝脏酶学对了解乙肝体内免疫状态、临床诊断和预后有重要意义。%Objective To investigate the relationship between serum in patients with chronic hepatitis B of different HBV-DNA load and inflammatory factor , liver function enzymes .Methods Seventy-eight cases of chronic hepatitis B patients were received real-time fluorescence quantitative PCR detection of serum HBV-DNA load, and then they were divided into negative group (17 cases), low load group (30 cases), median load group (19 cases), high load group (12 cases).High sensitivity C reactive protein (Hs-CRP), tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6), liver function enzymes ( ALT, AST, GGT) level were compared among the four groups , and to explore the correlation among these factors .Results Along with the increase of HBV-DNA load, TNF-α, IL-6 were significantly increased , revealed as high load group >median load group >low load group >positive group, there was statistically significant difference among these groups ( P <0.05). No statistical significance were found within group ( P >0.05).There were no significant differences between median and low load group of the levels of serum hs-CRP( P >0.05), the difference between the rest 2 groups was statistically significant ( P <0.05).Comparison of serum ALT, AST, GGT levels among these groups , it showed as high load group >median load group>low load group >negative group, there was significant difference among these groups ( P <0.05).ALT and TNF-α, IL-6 were positive correlated ( r =0.68, r =0.56, P <0.05);there is no correlation between ALT and hs CRP ( r =0.23,P>0.05).Conclusion Inflammatory cytokines have an important role in the pathogenesis of hepatitis B , comprehensive detec-tion of serum inflammatory cytokines and liver enzymes have significant for understanding the immune status of hepatitis B in vivo, clinical diagnosis and prognosis .
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