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慢性乙型肝炎患者肝内乙型肝炎病毒总DNA的定量分析及其与肝脏组织学的关系。

Quantification of intrahepatic total hepatitis B virus DNA in chronic hepatitis B patients and its relationship with liver histology.

作者信息

Bayram A, Erkilic S, Ozkur A, Bayram M, Sari I

机构信息

Department of Microbiology and Clinical Microbiology, School of Medicine, University of Gaziantep, Turkey.

出版信息

J Clin Pathol. 2008 Mar;61(3):338-42. doi: 10.1136/jcp.2007.050765. Epub 2007 Aug 10.

Abstract

AIMS

This study was conducted to evaluate the relationship between total intrahepatic hepatitis B virus (HBV) DNA levels and liver histology in terms of the degree of histological activity index (HAI) that yields necroinflammation (HAI-NI) and fibrosis (HAI-F) of the liver.

METHODS

Prospectively, Tru-cut needle biopsy samples were obtained from the livers of 42 patients with chronic hepatitis B. Levels of serum and liver HBV DNA were determined by quantitative real-time PCR. Demographic data of patients, together with hepatitis B serology, alanine aminotransferase levels, and HAI-NI and HAI-F scores, were recorded.

RESULTS

Twenty of the patients were hepatitis B e antigen (HBeAg) positive, while 22 patients were positive for antibody to HBeAg (anti-HBe). Serum and liver total HBV DNA levels were found to correlate directly with each other in the two groups (r = 0.669, p = 0.001; and r = 0.880, p<0.001; respectively) and the correlation was more marked in anti-HBe-positive patients. Although serum HBV DNA levels correlated positively with HAI-NI and HAI-F scores in HBeAg-positive and HBeAg-negative patients, total liver HBV DNA levels correlated with HAI-NI and HAI-F scores in anti-HBe-positive patients only.

CONCLUSIONS

Quantitative measurement of intrahepatic HBV DNA is a valuable marker of the histological status of the liver in anti-HBe-positive patients with chronic hepatitis B, and it may give an insight into the prognosis and the ideal time for the cessation of antiviral treatment.

摘要

目的

本研究旨在根据肝脏组织学活动指数(HAI)中产生坏死性炎症(HAI-NI)和纤维化(HAI-F)的程度,评估肝内乙型肝炎病毒(HBV)总DNA水平与肝脏组织学之间的关系。

方法

前瞻性地从42例慢性乙型肝炎患者的肝脏中获取Tru-cut针吸活检样本。通过定量实时PCR测定血清和肝脏HBV DNA水平。记录患者的人口统计学数据,以及乙肝血清学、丙氨酸转氨酶水平和HAI-NI及HAI-F评分。

结果

20例患者乙肝e抗原(HBeAg)阳性,22例患者乙肝e抗体(抗-HBe)阳性。在两组中均发现血清和肝脏HBV总DNA水平直接相关(分别为r = 0.669,p = 0.001;r = 0.880,p<0.001),且在抗-HBe阳性患者中相关性更明显。虽然在HBeAg阳性和HBeAg阴性患者中血清HBV DNA水平与HAI-NI和HAI-F评分呈正相关,但仅在抗-HBe阳性患者中肝脏HBV总DNA水平与HAI-NI和HAI-F评分相关。

结论

肝内HBV DNA的定量检测是抗-HBe阳性慢性乙型肝炎患者肝脏组织学状态的一个有价值的标志物,它可能有助于深入了解预后及抗病毒治疗停药的理想时机。

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