血清ALT及HBsAg、HBeAb水平与慢性HBV感染患者肝功能及其预后的关系<sup>*</sup>

doi:10.3969/j.issn.1671-7171.2024.10.002

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摘要【目的】探讨血清谷丙转氨酶(ALT)、乙型肝炎表面抗原(HBsAg)、乙型肝炎e抗体(HBeAb)水平与慢性乙型肝炎病毒(HBV)感染患者肝功能及其预后的关系。【方法】回顾性分析116例慢性HBV感染患者的临床资料,依据HBV感染进展情况分组,单纯慢性HBV感染为预后良好组(n=60),进展为肝硬化及肝癌患者为预后不良组(n=56)。比较两组一般资料,ALT、HBsAg及HBeAb水平。分析ALT、HBsAg、HBeAb预测患者预后不良的价值、患者预后不良的影响因素及三项指标与患者肝功能的关系。【结果】预后不良组肝功能分级为B级和C级人数占比,血清ALT及HBsAg、HBeAb定量水平高于预后良好组(P<0.05);受试者工作特征(ROC)曲线分析显示:ALT、HBsAg、HBeAb水平均可用于患者预后不良的预测中,曲线下面积分别为0.984、0.926、0.956(均P<0.05);多因素Logistic回归分析显示,肝功能分级B级和C级、ALT≥235.67 U/L、HBsAg≥708.45 IU/mL、HBeAb≥56.153 INH%是慢性HBV感染患者预后不良的危险因素(P<0.05);相关性分析显示,血清ALT、HBsAg、HBeAb定量水平与肝功能分级呈正相关(P<0.05)。【结论】血清ALT、HBsAg、HBeAb水平与慢性HBV感染患者肝功能分级呈正相关,肝功能分级B级和C级、ALT≥235.67 U/L、HBsAg≥708.45 IU/mL、HBeAb≥56.153 INH%是慢性HBV感染患者预后不良的危险因素,可作为监测慢性HBV感染患者病情的重要指标,为临床诊断和治疗提供参考。

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	吴靓菲
	孙志刚
	易本喜

关键词 ：乙型肝炎病毒, 慢性病, 乙型肝炎表面抗原, 丙氨酸转氨酶, 肝功能试验

Abstract：【Objective】To explore the relationship of serum levels of alanine aminotransferase (ALT), hepatitis B surface antigen (HBsAg), and hepatitis B e antibody (HBeAb) with liver function and prognosis in patients with chronic hepatitis B virus (HBV) infection. 【Methods】A retrospective analysis of clinical data from 116 patients with chronic HBV infection was conducted. The patients were divided into two groups based on the progression of HBV infection: the good prognosis group with simple chronic HBV infection (n=60) and the poor prognosis group with progression to cirrhosis and liver cancer (n=56). General data, ALT, HBsAg, and HBeAb levels were compared between the two groups. The value of ALT, HBsAg, and HBeAb in predicting poor prognosis and the influencing factors of poor prognosis, as well as the relationship between these three indicators and liver function, were analyzed. 【Results】The proportion of patients with liver function graded as B and C, and the levels of serum ALT, HBsAg, and HBeAb were higher in the poor prognosis group compared to the good prognosis group (P<0.05). Receiver Operating Characteristic (ROC) curve analysis showed that ALT, HBsAg, and HBeAb levels were able to use to predict poor prognosis in patients, with the area under the curve being 0.984, 0.926, and 0.956, respectively (all P<0.05). Multivariate Logistic regression analysis revealed that liver function grades B and C, ALT≥235.67 U/L, HBsAg≥708.45 IU/mL, and HBeAb≥56.153 INH% were risk factors for poor prognosis in patients with chronic HBV infection (P<0.05). Correlation analysis indicated that serum levels of ALT, HBsAg, and HBeAb were positively correlated with liver function grading (P<0.05). 【Conclusion】Serum levels of ALT, HBsAg, and HBeAb are positively correlated with liver function grading in patients with chronic HBV infection. Liver function grades B and C, ALT≥235.67 U/L, HBsAg≥708.45 IU/mL, and HBeAb ≥ 56.153 INH% are risk factors for poor prognosis in patients with chronic HBV infection. These indicators can serve as important markers for monitoring the condition of chronic HBV infection patients, providing references for clinical diagnosis and treatment.

Key words： Hepatitis B Virus Chronic Disease Hepatitis B Surface Antigens Alanine Transaminase Liver Function Tests

收稿日期: 2023-10-24

中图分类号:

R512.62

基金资助:^*上海市科学技术委员会科技计划项目(No.21ZR1447800)

通讯作者: **E-mail:fly5812@163.com

引用本文:

吴靓菲, 孙志刚, 易本喜. 血清ALT及HBsAg、HBeAb水平与慢性HBV感染患者肝功能及其预后的关系^*[J]. 医学临床研究, 2024, 41(10): 1461-1464.
WU Liangfei, SUN Zhigang, YI Benxi. Relationship of Serum Levels of ALT, HBsAg, and HBeAb with Liver Function and Prognosis in Patients with Chronic HBV Infection. JOURNAL OF CLINICAL RESEARCH, 2024, 41(10): 1461-1464.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2024.10.002 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2024/V41/I10/1461

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