Gao P, Xiao P, Yang Y L, Chen Q F, Mao X R, Zhao Z B, Shi L, Yang L Z, Zhou W
Institute of Infection, First Hospital of Lanzhou University, Lanzhou 730000, China.
Department of Infection, First Hospital of Lanzhou University, Lanzhou 730000, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2014 Dec 18;46(6):941-4.
To evaluate the effect of the viral load on the red blood cell parameters in chronic hepatitis B patients and its clinical significance.
In the study, 373 chronic hepatitis B patients were recruited, including 123 alanine transaminase (ALT) normal patients (ALT<40 U/L),128 ALT greater than or equal to the upper limit of normal, and less than 2 times higher than the upper limit of normal patients(40 U/L ≤ALT<80 U/L), and 122 ALT greater than or equal to 2 times higher than the upper limit of normal patients (ALT≥80 U/L). The blood routine parameters were measured by automatic blood cell counter. The liver function parameters were measured by automatic biochemical analyzer, the hepatitis B virus loads were measured by quantitative PCR analyzer and the results were analyzed by covariance analysis.
In the ALT normal chronic hepatitis B patients group, the viral load had minor effects on the red blood cell parameters.But in the ALT abnormal chronic hepatitis B patients group, the viral load had a significant effect on the red blood cell parameters, and the effect was most manifest in the ALT≥ double upper limit of normal group. The specific performance was that with the viral load increasing, the red blood cell [low copies group (4.10±0.67)×10(12)/L,medium copies group (3.92±0.69)×10(12)/L,high copies group (3.54±0.90) ×10(12)/L], the hemoglobin[low copies group (129.66±21.12 ) g/L, medium copies group (126.23±23.38) g/L, high copies group (112.98±27.77) g/L], the hematocrit (low copies group 37.66±5.68, medium copies group 37.03±6.03, high copies group 33.34±8.15) decreased(P=0.006,0.007,0.010),the mean corpuscular volume [low copies group (92.17±6.53) fL, medium copies group (94.85±7.95) fL, high copies group (101.63±11.33) fL], the mean corpuscular hemoglobin [low copies group (31.70±2.22) pg, medium copies group (33.11±3.62) pg, high copies group (34.65±3.13) pg], the mean corpuscular hemoglobin concentration [low copies group (344.28±17.17) g/L, medium copies group (351.33±16.90) g/L, high copies group (358.12±15.67) g/L], and the red blood cell distribution width-standard deviation [low copies group (52.49±9.04) fL, medium copies group (56.96±7.19) fL, high copies group (61.23 ±7.23) fL] increased(P=0.000,0.000,0.002,0.000).
Observing the effect of the viral load on the red blood cell parameters in chronic hepatitis B patients can reflect the effect of hepatitis B virus on the immune response and liver function in the different pathological stages, providing theoretical support for the clinical antiviral treatment.
评估病毒载量对慢性乙型肝炎患者红细胞参数的影响及其临床意义。
本研究纳入373例慢性乙型肝炎患者，其中丙氨酸转氨酶（ALT）正常患者（ALT<40 U/L）123例，ALT大于或等于正常上限且低于正常上限2倍患者（40 U/L≤ALT<80 U/L）128例，ALT大于或等于正常上限2倍患者（ALT≥80 U/L）122例。采用血细胞自动分析仪检测血常规参数，自动生化分析仪检测肝功能参数，定量PCR分析仪检测乙型肝炎病毒载量，并采用协方差分析进行结果分析。
在ALT正常的慢性乙型肝炎患者组中，病毒载量对红细胞参数影响较小。但在ALT异常的慢性乙型肝炎患者组中，病毒载量对红细胞参数有显著影响，且在ALT≥正常上限2倍组中影响最为明显。具体表现为随着病毒载量升高，红细胞[低拷贝组（4.10±0.67）×10¹²/L，中拷贝组（3.92±0.69）×10¹²/L，高拷贝组（3.54±0.90）×10¹²/L]、血红蛋白[低拷贝组（129.66±21.12）g/L，中拷贝组（126.23±23.38）g/L，高拷贝组（112.98±27.77）g/L]、血细胞比容（低拷贝组37.66±5.68，中拷贝组37.03±6.03，高拷贝组33.34±8.15）降低（P=0.006、0.007、0.010），平均红细胞体积[低拷贝组（92.17±6.53）fL，中拷贝组（94.85±7.95）fL，高拷贝组（101.63±11.33）fL]、平均红细胞血红蛋白含量[低拷贝组（31.70±2.22）pg，中拷贝组（33.11±3.
