乙肝病毒血清标志物及ALT相关性分析.docVIP

乙肝病毒血清标志物及ALT相关性分析 　【摘要】 目的：观察乙型肝炎表面抗原（HBsAg）阳性者乙肝病毒核心抗体IgM(HBc-IgM)及其他血清病毒标志物(HBsAb、 HBcAb、 HBeAg、 HBeAb)不同阳性结果时血清丙氨酸氨基转移酶(ALT)的变化，分析其相关性。方法：检测1056例HBsAg阳性者血清病毒标志物和ALT，依据乙肝病毒标志物阳性情况的不同分为A、B、C、D共4组。计算各组ALTgt;40 U/L的例数及其百分率。结果：ALT异常增高的例数及其百分率分别为A组174例（76.7%)，B组105例(55.3%)，C组22例（21.4%），D组123例(23.2%)，A、B组分别与C、D组间ALT异常增高率差异有统计学意义(Plt;0.05)。结论：在临床上同时检测抗HBc-IgM及各项血清学病毒标志物对了解乙型肝炎患者的病情和指导治疗具有较大的价值。 【关键词】 乙型肝炎病毒；表面抗原；核心抗体IgM；丙氨酸氨基转移酶 [Abstract] Objective: To observe the change of alanine aminotransferase (ALT) in hepatitis B surface antigen (HBsAg) positive patients? serum with different positive groups of hepatitis B core antibody IgM (HBc-IgM) and other hepatitis B serological markers (HBsAb, HBcAb, HBeAg, HBeAb). Methods: Serum markers of virus and ALT from 1056 HBsAg positive patients were detected by using enzyme-linked immunosorbent assay(ELSIA) and enzyme rate method. The 1056 cases were divided into 4 groups according to the positive situation of HBV serum markers , and then in each group the number and the percentage of ALTgt;40 U/L were counted. Results: The number and the percentage were as follows: 174 cases(76.7%) in group A, 105 cases(55.3%) in group B, 22 cases(21.4%) in group C and 123 cases (23.2%) in group D. There was significant difference of ALT abnormal increase rate between A, B groups and C, D groups separately (Plt;0.05), but there is no significant difference between group C and D（Pgt;0.05）. Conclusions: The ALT increase rate of HBc-IgM positive serum from HBsAg positive patients is more significant than that of HBc-IgM negative serum. [Key words] Hepatitis B virus；Hepatitis B surface antigen；Hepatitis B core antibody-IgM； Alanine aminotransferase 全世界约有4亿乙型肝炎病毒（HBV）感染者, 其中约2%~5%为慢性感染[1]，我国HBV携带者超过1亿。目前临床上用于乙型肝炎诊断的血清免疫学检测项目主要包括乙型肝炎表面抗原（HBsAg）、乙型肝炎表面抗体（HBsAb）、核心抗体（HBcAb）、 e抗原（HBeAg）、e抗体（HBeAb）(即通常俗称的“二对半”)及乙肝病毒核心抗体IgM（HBc-IgM）、乙肝病毒脱氧核糖核酸（HBV DNA）等，其中HBc-IgM是诊断急性乙型肝炎和慢性乙型肝炎活动期的重要血清学标志；“二对半”各项指标与HBV复制及疾病不同阶段有关；而丙氨酸氨基转移酶（ALT）在肝炎急性期升高明显，是判断肝脏损害程度的主要指标