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临床输血与检验

临床输血与检验 ›› 2024, Vol. 26 ›› Issue (1): 117-122.DOI: 10.3969/j.issn.1671-2587.2024.01.018

• 临床检验 • 上一篇    下一篇

CHB血清核心抗体与HBV-DNA、HBsAg、肝脏组织纤维化分期相关性及临床意义*

姚挺英, 柳丽娟, 廖柏涛, 魏玉仙   

  1. 福建医科大学孟超肝胆医院（金山院区）检验科,福建福州 350007
  • 收稿日期:2023-07-07 发布日期:2024-03-13
  • 作者简介:姚挺英,主要从事感染性疾病免疫学检研究,（E-mail）shasen85@21cn.com
  • 基金资助:
    *本课题受福州市“十四五”临床专科培优项目（医学检验科）（No. 20220203）资助

Correlation and Clinical Significance of CHB Serum Core Antibody with HBV-DNA, HBsAg and Hepatic Fibrosis Stage

YAO Tingying, LIU Lijuan, LIAO Baitao, WEI Yuxian   

  1. Department of Clinical Laboratory, Jinshan Hospital of Mengchao Liver and Gallbladder, Fujian Medical University, Fuzhou 350007
  • Received:2023-07-07 Published:2024-03-13

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摘要： 目的 探讨慢性乙型肝炎（CHB）患者血清核心抗体（HBcAb）与乙肝病毒脱氧核糖核酸（HBV-DNA）、乙肝表面抗原（HBsAg）、肝脏组织纤维化分期相关性及临床意义。方法 选取我院2018年1月—2022年12月收治的CHB患者作为研究对象,根据纤维化严重程度分为轻度组（S0~S1期,50例）、中重度组（S2~S4期,150例）,比较两组患者临床资料和实验室指标,应用Spearman/Pearson分析HBcAb与HBV-DNA、HBsAg、肝脏组织纤维化分期相关性;运用LASSO回归筛选变量;诊断效能分析采用受试者工作特征曲线（ROC）。结果 单因素分析显示,中重度组病程长于轻度组,肝脏炎症分级分布较轻度组严重,ALT、AST、总胆红素（TBIL）、碱性磷酸酶（ALP）、层粘连蛋白、Ⅲ型前胶原N端肽、透明质酸、Ⅳ型胶原、HBcAb高于轻度组,HBV-DNA、HBsAg低于轻度组（P<0.05）;HBCAb与肝纤维化呈正相关,HBV-DNA、HBsAg与肝脏组织纤维化分期呈负相关（P<0.05）;将单因素分析P<0.05的13个变量进行LASSO回归分析筛选出4个变量肝脏炎症分级、HBcAb、HBV-DNA、HBsAg,其是中重度肝纤维化相关影响因素（P<0.05）;肝脏炎症分级、HBcAb、HBV-DNA、HBsAg联合诊断中重度肝脏组织纤维化的AUC优于任一单一项目。结论 HBCAb与肝纤维化呈正相关,HBV-DNA和HBSAg与肝纤维化负相关,以上指标均是中重度肝纤维化相关影响因素,具有一定诊断价值,为临床预测中重度肝纤维化提供一定参考。

关键词: CHB, 核心抗体, HBV-DNA, HBsAg, 肝脏组织, 纤维化分期

Abstract: Objective To investigate the correlation and clinical significance of hepatitis B core antibody (HBcAb) with hepatitis B virus deoxyribonucleic acid (HBV-DNA), Hepatitis B surface antigen (HBsAg) and liver fibrosis stage in patients with chronic hepatitis B (CHB). Methods CHB patients admitted to our hospital from January 2018 to December 2022 were selected as study objects, and were divided into mild group (stage S0-S1, 50 cases) and moderate and severe group (stage S2-S4,150cases) according to the severity of fibrosis. Clinical data and laboratory indicators in the two groups were compared. Spearman/Pearson was used to analyze the correlation between HBcAb and HBV-DNA, HBsAg and liver fibrosis stage. LASSO regression was used to screen variables. Receiver operating characteristic curve (ROC) was used to assess the diagnostic performance. Results Univariate analysis showed that the duration of disease in the moderate-severe group was longer; the grading distribution of liver inflammation was more severe; ALT, AST, total bilirubin, alkaline phosphatase, laminin, type III procollagen N-terminal peptide, hyaluronic acid, type IV collagen and HBcAb were higher; HBV-DNA and HBsAg were lower compared with the mild group (P<0.05). HBcAb was positively correlated with liver fibrosis, and HBV-DNA and HBsAg were negatively correlated with liver tissue fibrosis staging (P<0.05). The 13 variables with P<0.05 in univariate analysis were screened out 4 to identify four variables liver inflammation grade, HBcAb, HBV-DNA and HBsAg by LASSO regression, which were related factors of moderate and severe liver fibrosis (P<0.05). The AUC for the combination of liver inflammation grading, HBcAb, HBV-DNA and HBsAg in the diagnosis of moderate and severe liver fibrosis was superior to any single test. Conclusion HBcAb was positively correlated with liver fibrosis, while HBV-DNA and HBsAg were negatively correlated with liver fibrosis. All the above indicators are related factors for moderate to severe liver fibrosis, which have certain diagnostic value and provide cetrain reference for clinical prediction of moderate to severe liver fibrosis.

Key words: CHB, Core antibody, HBV-DNA, HBsAg, Liver tissue, Fibrosis staging

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