乙肝两对半联合ALT、AST及HBV-DNA检测的临床相关性分析

Clinical Correlation Analysis of Hepatitis B Virus Serological Markers Combined with ALT, AST and HBV-DNA Detection

摘要: 目的：研究分析乙型肝炎病毒DNA (HBV-DNA)载量与乙肝不同两对半模式以及丙氨酸氨基转移酶(ALT)和天冬氨酸氨基转移酶(AST)浓度之间的关系。方法：使用回顾性分析，对本院2024年3月至2025年3月间的224例乙型肝炎病毒阳性样本进行研究。乙肝两对半通过化学发光技术检测，HBV-DNA借助实时荧光定量PCR技术测量，丙氨酸氨基转移酶(ALT)使用丙氨酸底物法评估，天冬氨酸氨基转移酶(AST)采用天门冬氨酸底物法进行测定，所有数据均经过统计学方法分析处理。结果：在HBV-DNA阳性水平上，不同乙肝两对半组合出现了不同的结果。其中大三阳组(HBsAg⁺ HBeAg⁺ HBcAb⁺)阳性率显著高于小三阳组(HBsAg⁺ HBeAb⁺ HBcAb⁺)，差异有统计学意义(P < 0.05)，与其他各组相比，差异无统计学意义(P > 0.05)。以ALT和AST阳性为基础，在乙肝两对半不同模式间，大三阳组(HBsAg⁺ HBeAg⁺ HBcAb⁺) ALT和AST的总阳性率均显著高于小三阳组(HBsAg⁺ HBeAb⁺ HBcAb⁺)，差异有统计学意义(P < 0.05)。在不同乙肝两对半模式下，大三阳组(HBsAg⁺ HBeAg⁺ HBcAb⁺) HBV-DNA载量与ALT和AST无相关性(r = −0.034, P = 0.838; r = −0.249, P = 0.131)；小三阳组(HBsAg⁺ HBeAb⁺ HBcAb⁺) HBV-DNA载量与ALT和AST无相关性(r = 0.117, P = 0.139; r = 0.121, P = 0.126)。总体上，HBV-DNA载量与ALT和AST是正相关(r = 0.257, P < 0.001; r = 0.211, P = 0.001)。结论：HBV-DNA测试结果与乙肝两对半存在显著关联，结合分析丙氨酸氨基转移酶(ALT)和天冬氨酸氨基转移酶(AST)的水平，有助于提升乙肝的筛查、诊断和治疗效果。

Abstract: Objective: To study and analyze the relationship between hepatitis B virus DNA (HBV-DNA) load and different hepatitis B virus serological markers, as well as the concentrations of alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Methods: Retrospective analysis was used to study 224 cases of hepatitis B virus positive samples in our hospital from March 2024 to March 2025. Hepatitis B virus serological markers were detected by chemiluminescence, HBV-DNA was measured by real-time fluorescence quantitative PCR, alanine aminotransferase (ALT) was evaluated by the alanine substrate method, and aspartate aminotransferase (AST) was determined by the aspartate substrate method. All the data were analyzed and processed by statistical methods. Results: On the positive level of HBV-DNA, different hepatitis B virus serological markers showed different results. Among them, the positive rate of Big Sanyang Group (HBsAg⁺ HBeAg⁺ HBcAb⁺) was significantly higher than that of Small Sanyang Group (HBsAg⁺ HBeAb⁺ HBcAb⁺), and the difference was statistically significant (P < 0.05), but there was no statistical difference among other groups (P > 0.05). Based on the positive rates of ALT and AST, the total positive rates of ALT and AST in the Big Sanyang group (HBsAg⁺ HBeAg⁺ HBcAb⁺) were significantly higher than those in the Small Sanyang group (HBsAg⁺ HBeAb⁺ HBcAb⁺), and the difference was statistically significant across different hepatitis B virus serological markers (P < 0.05). There was no correlation between HBV-DNA load and ALT and AST in the Big Three-Yang Group (HBsAg⁺ HBeAg⁺ HBcAb⁺) (r = −0.034, P = 0.838; r = −0.249, P = 0.131); There was no correlation between HBV-DNA load and ALT and AST in Xiaosanyang group (HBsAg⁺ HBeAB⁺ HBcAb⁺) (r = 0.117, P = 0.139; r = 0.121, P = 0.126). Generally speaking, HBV-DNA load is positively correlated with ALT and AST (r = 0.257, P < 0.001; r = 0.211, P = 0.001) across different hepatitis B virus serological markers. Conclusion: There is a significant correlation between HBV-DNA test results and hepatitis B virus serological markers. Combined analysis of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels is helpful to improve the screening, diagnosis and treatment of hepatitis B.