乙肝病毒表面大蛋白在慢性乙型肝炎肝纤维化诊断中的应用探讨

摘要

目的 探讨慢性乙型肝炎各个阶段乙肝病毒表面大蛋白(LHBs)含量与肝纤维化指标的关系.方法 选取HBeAg(-)患者42例(其中肝炎患者20例,肝硬化患者22例),HBeAg(+)患者38例(其中肝炎患者20例,肝硬化患者18例),检测其LHBs水平及肝纤维化指标水平(HA,LN,PC-III和IV-C),并与20例健康成人进行比较,分析各指标的变化特点及相关性.结果 ①肝炎组明显高于正常对照组(t=8.825,P=0.000),肝硬化组明显高于正常对照组(t=13.003,P=0.000),肝炎组与肝硬化组差异均有统计学意义(t=0.648,P=0.521)②其中HBeAg(-)肝炎组明显低于肝硬化组(t=40.61,P=0.000),而HBeAg(+)肝炎组与肝硬化组差异无统计学意义(t=0.643,P=0.524);四项纤维化指标HBeAg(-)和HBeAg(+)肝硬化组均明显高于肝炎组(P<0.05).③HBeAg(-)组LHBs和HA,PC-III之间存在线性相关(P<0.05);HBeAg(+)组LHBs和肝纤维化指标之间不存在线性相关(P>0.05).结论 LHBs可以预测HBeAg(-)患者的肝纤维化的发生,并且在一定程度上反映HBeAg(-)患者的肝纤维化程度,但是在HBeAg(+)患者LHBs不能反映肝脏纤维化的程度.%Objective To explore the change of the hepatitis B surface protein (LHBs) in the stages of chronic hepatitis B,and the relationship between LHBs and the index of liver fibrosis. Methods Selected 42 HBeAg( -) (20 chronic hepatitis B and 22 cirrhosis),38 HBeAg(+)(20 chronic hepatitis Band 18 cirrhosis) and 20 healthy adults, tested their LHBs level and the index of liver fibrosis (HA, LN > PC Ⅲ and Ⅳ C). Then analysed of the data. Results ①Hepatitis group was obviously higher than that of normal control group (t=8. 825, P=0. 000) ,liver cirrhosis group was obviously higher than that of nor Trial control group (t=13. 003,P=0. 000) ,the difference between hepatitis group and liver cirrhosis group was not statisti cally significant (t=0. 648, P= 0. 521). ②The HBeAg( -) hepatitis group was significantly lower than the liver cirrhosis group (t=40.61,P=0. 000) ,and the difference between HBeAg ( + ) hepatitis group and liver cirrhosis group was not sta tistically significant (t=0. 643 ,P=0. 524). Four fibrosis index of HBeAg ( -) and HBeAg( + ) cirrhosis group were signif icantly higher than that of hepatitis group (P<0. 05). ③Analysis of the HBeAg(-) group obtained: LHBs and HA and PC Ⅲ was positively correlated (P<0. 05) ithere's no correlationship between LHBs and index of liver fibrosis in HBeAg ( + ) group. Conclusion LHBs can predict HBeAg( -) patients'liver fibrosis and reflect the degree of liver fibrosis to some extent. But LHBs cannot reflect the liver fibrosis in HBeAg( + ) patients.