摘要
目的探讨和评价血清乙型肝炎核心相关抗原(HBcrAg)预测慢性乙型肝炎(CHB)肝组织炎症活动度和纤维化程度的效能。方法 CHB患者211例,其中HBeAg阳性和阴性患者分别为125例和86例。血清HBcrAg采用化学发光酶免疫法检测。数据处理和统计分析采用SPSS 16.0软件。结果 HBeAg阳性患者,血清HBcrAg与肝组织病理学分级和分期均呈显著负相关(r_s=-0.305,P=0.001和r_s=-0.370,P=0.000),在不同病理学分级和分期之间的差异均有统计学意义(r_s=16.756,P=0.000和r_s=25.003,P=0.000)。HBeAg阴性患者,血清HBcrAg与病理学分级和分期均呈显著正相关(r_s=0.476,P=0.000和r_s=0.556,P=0.000),在不同病理学分级和分期之间的差异均有统计学意义(r_s=22.529,P=0.000和r_s=26.416,P=0.000)。HBeAg阳性患者,血清HBcrAg预测病理学分级≥G3和分期≥S3的ROC曲线下面积分别为0.722和0.739(P=0.000和P=0.000);以血清HBcrAg≤4.81×104 kU/mL和≤8.13×104 kU/mL为标准,其预测病理学分级≥G3和分期≥S3的灵敏度、特异度、准确度分别为0.706、0.714、0.712和0.821、0.698、0.736。HBeAg阴性患者,血清HBcrAg预测病理学分级≥G2和分期≥S2的ROC曲线下面积分别为0.807和0.799(P=0.000和P=0.000);以血清HBcrAg≥40.18 kU/mL和≥10.64 kU/mL为标准,其预测病理学分级≥G2和分期≥S2的灵敏度、特异度、准确度分别为0.821、0.724、0.756和0.775、0.696、0.733。结论血清HBcrAg能有效地预测HBeAg阳性患者的肝组织严重炎症活动度和严重纤维化程度以及HBeAg阴性患者的肝组织显著炎症活动度和显著纤维化程度。
Objective To appraise the efficacy of serum hepatitis B core-related antigen（HBcrAg）in prediction of the inflammatory activity and fibrotic level of liver tissue in patients with chronic hepatitis B.Methods Two hundred and eleven patients with chronic hepatitis B,including 125 hepatitis B e antigen（HbeAg）-positive and 86 HBeAg-negative patients,were enrolled in the study.Serum HBcrAg were measured by chemiluminescence enzyme immunoassay.SPSS16.0software was used for data processes and statistical analyses.Results In HBeAg-positive patients,serum HBcrAg had a significantly negative correlation with pathological grading and staging（r_s=-0.305,P=0.001 和r_s=-0.370,P=0.000）,which showed statistically significant differences in different pathological grading and staging（r_s =16.756,P=0.000 和 r_s=25.003,P=0.000）.In HBeAg-negative patients,serum HBcrAg was significantly positively correlated with pathological grading and staging（r_s=0.476,P=0.000和r_s=0.556,P=0.000）,which showed statistically significant difference in different pathological grading and staging（r_s=22.529,P=0.000和r_s=26.416,P=0.000）.In HBeAg-positive patients,the areas under the receiver operating characteristic（ROC）curve of serum HBcrAg in prediction of pathological grading≥G3 and staging ≥S3 were 0.722 and 0.739（P=0.000 and P=0.000）,respectively.The sensitivities,specificities and accuracies in prediction of pathological grading ≥G3 and staging ≥S3 were 0.706,0.714,0.712 and 0.821,0.698,0.736,respectively,when the cut-off values of serum HBcrAg were not more than 4.81×104 kU/mL and 8.13×104 kU/mL.In HBeAg-negative patients,the areas under the ROC curve of serum HBcrAg in prediction of pathological grading≥G2 and staging ≥S2 were 0.807 and 0.799（P=0.000 and P=0.000）,respectively.taking serum HBcrAg ≥40.18 kU/mL and ≥10.64 kU/mL as cut-offs,The sensitivities,specificities and accuracies in prediction of pathological grading≥G2and staging ≥S2 were 0.821,0.724,0.756 and 0.775,0.696,0.733,respectively,when the cut-off values of serum HBcrAg were not less than 40.18 kU/mL and 10.64 kU/mL.Conclusion Serum HBcrAg can effectively predict severe inflammatory activity and severe fibrotic level of liver tissue in HBeAg-positive patients,as well as HBeAg-negative patients.
出处
《肝脏》
2015年第8期576-582,共7页
Chinese Hepatology
基金
上海市卫生和计划生育委员会科研项目(20134032)
国家"十二五"传染病防治重大科技专项(2013ZX10002005)
关键词
慢性乙型肝炎
乙型肝炎核心相关抗原
定量检测
肝纤维化
无创诊断
Chronic hepatitis B
Hepatitis B core-related antigen
Quantitative detection
Liver fibrosis
Noninvasive diagnosis
