慢性乙型肝炎患儿HBV DNA载量与肝脏病理、肝功能、肝纤维化血清学指标的相关性分析

覃小梅; 范宸颖; 李双杰; 彭慧云

doi:10.3969/j.issn.1001-5256.2016.03.014

慢性乙型肝炎患儿HBV DNA载量与肝脏病理、肝功能、肝纤维化血清学指标的相关性分析

DOI: 10.3969/j.issn.1001-5256.2016.03.014

南华大学儿科学院
湖南省儿童医院肝病中心

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中图分类号: R725.1
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- 出版日期: 2016-03-20

Correlation of HBV DNA load with liver pathology,liver function,and serological markers of liver fibrosis in children with chronic hepatitis B

The Pediatric Academy of University of South China

摘要

摘要: 目的探讨慢性乙型肝炎（CHB）患儿HBV DNA载量与肝脏病理及肝功能、肝纤维化血清学指标的关系。方法收集2010年7月-2015年6月湖南省儿童医院肝病中心收治的确诊为CHB的患儿79例,根据患儿血清HBV DNA载量分为低载量组（103拷贝/ml
- 肝炎,乙型,慢性 /
- 病毒载量 /
- 病理学,临床 /
- 儿童
Abstract: Objective To investigate the correlation of HBV DNA load with liver pathology,liver function,and serological markers of liver fibrosis in children with chronic hepatitis B( CHB). Methods A total of 79 children with a confirmed diagnosis of CHB who were admitted to Liver Research Center of Children's Hospital of Hunan Province from July 2010 to June 2015 were selected,and according to the serum HBV DNA load,they were divided into low load group( 103< HBV DNA load≤105copies / ml,n = 8),medium load group( 105< HBV DNA load ≤107copies / ml,n = 54),and high load group( HBV DNA load > 107 copies / ml,n = 17). The degree of liver pathological changes and serum levels of alanine aminotransferase( ALT),aspartate aminotransferase( AST),procollagen type Ⅲ( PC Ⅲ),laminin( LN),hyaluronic acid( HA),and type Ⅳ collagen( Ⅳ- C) were compared between the groups. The Kruskal- Wallis rank sum test was applied for comparison of continuous data between groups,and Kendall's tau- b rank correlation analysis was applied for correlation analysis. Results The three groups mainly had a liver inflammation grade of G1,which accounted for 75%,74. 1%,and 64. 7%,respectively,and the high load group had an increased proportion of G2 patients( 35. 5%). The three groups mainly had a fibrosis stage of S1,which accounted for 75. 0%,72. 2%,and 70. 6%,respectively,and there were S4 patients in the low load group( 12. 5%). HBV DNA load was not correlated with liver inflammation grade or fibrosis stage( r = 0. 069 and- 0. 047,both P > 0. 05). The medium load group had higher serum levels of ALT and AST than the low load group,and the high load group had higher serum levels of ALT and AST than the medium load group; serum ALT level showed a significant difference between the three groups( χ2= 5. 37,P = 0. 048). The medium load group had lower serum levels of HA,LN,PCⅢ,and Ⅳ- C than the low load group,and the high load group had lower serum levels of HA,LN,PCⅢ,and Ⅳ- C than the medium group; serum PCⅢ level showed a significant difference between the three groups( χ2= 6. 26,P = 0. 044).Conclusion In children with CHB,HBV DNA load is not significantly correlated with liver pathology. A comprehensive analysis of HBV DNA load,liver function,and serological markers of liver fibrosis in clinical practice in combination with liver biopsy can achieve an objective and accurate evaluation of the conditions of children with CHB.
- hepatitis B,chronic /
- viral load /
- pathology,clinical /
- child

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参考文献(12)

[1]SOKAL EM,PAGANELLI M,WIRTH S,et al.Management of chronic hepatitis B in childhood:ESPGHAN clinical practice guidelines Consensus of an expert panel on behalf of the European Society of Pediatric Gastroenterology,Hepatology and Nutrition[J].J Hepatol,2013,59(4):814-829.

[2]YAN XH,LI JL,CHEN XY,et al.Research advances in shortand long-term efficacy of nucleos(t)ide analogues in treatment of HBV-related cirrhosis[J/CD].Chin J Liver Dis:Electronic Edition,2015,7(2):26-28.(in Chinese)闫雪华,李佳栗,陈小勇,等.核苷(酸)类药物治疗HBV相关肝硬化近、远期疗效研究进展[J/CD].中国肝脏病杂志:电子版,2015,7(2):26-28.

[3]LIANG X,BI S,YANG W,et al.Epidemiolgical serosurvey of hepatitis B in China-declining HBV prevalence due to hepatitis B vaccination[J].Vaccine,2009,27(47):6550-6557.

[4]LIANG X,BI S,YANG W,et al.Evaluation ofthe impact of hepatitis B vaccination among children born during 1992-2005 in China[J].J Infet Dis,2009,200(1):39-47.

[5] Chinese Society of Hepatology,Chinese Society of Infectious Diseases,Chinese Medical Association.The guideline of prevention and treatment for chronic hepatitis B(2010 version)[J].J Clin Hepatol,2011,27(1):1-16.(in Chinese)中华医学会肝病学分会,中华医学会感染病学分会.慢性乙型肝炎防治指南(2010年版)[J].临床肝胆病杂志,2011,27(1):1-16.

[6]HUI CK,LEUNG N,YUEN ST,et al.Natural history and disease progression in Chinese chronic hepatitis B patients in immune tolerant phase[J].Hepatology,2007,46(2):395-401.

[7]FAN JH,DAI H,GAO LQ,et al.Pathological analysis of liver tissues in 236 patients with chronic hepatitis B[J].Infect Dis Info,2009,22(6):361-363.(in Chinese)范晶华,戴虹,高柳青,等.慢性乙型肝炎236例肝组织病理分析[J].传染病信息,2009,22(6):361-363.

[8]GAN XR,TIAN L.Research progress on the correlation between cell signaling pathway and liver fibrosis[J].Med Recapitulate,2014,20(22):4063-4065.(in Chinese)甘信容,田黎.细胞信号转导通路与肝纤维化的研究进展[J].医学综述,2014,20(22):4063-4065.

[9]MUKHERJEE R,REDDY PB,ARAVA J,et al.Relalionship between semm HBs Ag level,HBV DNA level,and peripheml immune cells in patients with chmnic hepatitis B virus inbction[J].Hepat Med,2010,16(2):157-162.

[10]WU TF,XIA Y.Correlation between hepatitis B virus detection and liver injury:an analysis of 656 cases[J].Chin J Health Lab Technol,2011,21(1):135-136.(in Chinese)吴廷芳,夏涌.656例乙肝病毒检测与肝损伤的相关性分析[J].中国卫生检验杂志,2011,21(1):135-136.

[11]HUANG X,YANG Y,CUI ZW,et al.HBV-DNA correlation analysis of related biochemical indexes of quantitative and quantitative liver function and HBV serum markers[J].World Latest Med Inform,2015,15(2):16-17.(in Chinese)黄鑫,杨阳,崔智威,等.HBV-DNA定量与乙肝血清标志物定量及肝功能相关生化指标的相关性分析[J].世界最新医学信息文摘,2015,15(2):16-17.

[12]HUANG WQ,XU JC,MIN F,et al.Role of serological markers of liver fibrosis combined with liver biochemical test in evaluation of patients with chronic hepatitis B[J].Chin J Hepatol,2014,11(19):856-858.(in Chinese)黄文琪,许金超,闵峰,等.血清纤维化指标联合肝生化检测对慢性乙型肝炎患者病情的评估[J].中华肝脏病杂志,2014,11(19):856-858.

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