【摘要】 目的探讨慢性乙型肝炎(CHB)患者血清HBV DNA、HBeAg与肝组织HBcAg及炎症分级的关系。方法回顾性分析250例CHB肝穿刺患者,按血清HBV DNA水平,分为A组(<3 log10IU/ml)45例,B组(3~6 log10IU/ml)138例,C组(>6 log10IU/ml)67例。按HBeAg阴阳性不同分为阳性组142例,阴性组108例。分别与肝组织中HBcAg水平、肝组织炎症分级进行比较,分析彼此的相关性,率的比较用卡方检验及确切概率法,相关性分析采用直线相关分析。结果血清HBV DNA不同水平与肝组织HBcAg免疫组化比较差异有统计学意义(χ2=11.1,P=0.05),两者之间呈正相关(r=0.75,P=0.001);与肝组织炎症分级(G)比较差异无统计学意义(χ2=13.3,P=0.075),两者之间也无相关性(r=0.04,P=0.325)。HBeAg阳性和阴性分组与肝组织中HBcAg水平比较差异有统计学意义(χ2=6.64,P=0.01),两者之间呈正相关(r=0.56,P=0.001);与肝组织炎症分级(G)比较差异无统计学意义(χ2=8.43,P=0.065),两者之间也无相关性(r=0.06,P=0.415)。结论 CHB患者肝组织HBcAg表达更能反映出肝内HBV复制状态,患者血清中测不出病毒标志物时,可以考虑肝穿刺以观察肝组织中HBcAg表达来判断HBV复制状态具有重要意义。更多还原

【Abstract】 Objective To investigate the relationship between HBV DNA and HBeAg in serum and HBcAg and inflammation grade in liver tissue among chronic hepatitis B( CHB) patients. Methods A retrospective analysis was performed on 250 CHB patients who underwent liver biopsy. These patients were divided into three groups according to serum levels of HBV DNA: group A( < 3 log10IU / ml,n = 45),group B( 3-6 log10IU / ml,n = 138),and group C( > 6 log10IU / ml,n = 67),and they were also divided into HBeAg-positive group( n= 142) and HBeAg-negative group( n = 108). The positive rate of HBcAg and inflammation grade in liver tissue were compared between groups,and correlations were analyzed. Comparisons of rates were made by chi-square test and Fisher’s exact test; correlations were determined by linear correlation analysis. Results There were significant differences in positive rate of HBcAg between groups A,B,and C( χ2= 11. 1,P = 0. 05),and serum HBV DNA level was positively correlated with the positive rate of HBcAg in liver tissue( r = 0. 75,P =0. 001). There were no significant differences in inflammation grade between groups A,B,and C( χ2= 13. 3,P = 0. 075),and no correlation was found between serum HBV DNA level and inflammation grade in liver tissue( r = 0. 04,P = 0. 325). There was significant difference in positive rate of HBcAg between the HBeAg-positive group and HBeAg-negative group( χ2= 6. 64,P = 0. 01),and the presence or absence of HBeAg in serum was positively correlated with the positive rate of HBcAg in liver tissue( r = 0. 56,P = 0. 001). There was no significant difference in inflammation grade between the HBeAg-positive group and HBeAg-negative group( χ2= 8. 43,P = 0. 065),and no correlation was found between the presence or absence of HBeAg in serum and inflammation grade in liver tissue( r = 0. 06,P = 0. 415).Conclusion The expression of HBcAg in liver tissue can better reflect HBV replication in the liver among CHB patients. When HBV markers cannot be detected in the serum of patients,liver biopsy can be used to detect HBcAg in liver tissue and assess HBV replication.更多还原