Study on the application value of combined detection of serum hepatitis C virus-RNA level and liver function indices in diagnosis and treatment of hepatitis C patients / 中国医师进修杂志

ABSTRACT

Objective To explore the correlation between serum hepatitis C virus (HCV)-RNA level with cholinesterase (CHE), albumin (ALB) and prealbumin (PA) in patients with hepatitis C, and provide the references for the early diagnosis and the prognosis monitoring of hepatitis C. Methods Four hundred and fifty-five patients with hepatitis C were selected. The serum level of HCV-RNA was determined by quantitative real-time polymerase chain reaction (real-time PCR), and serum levels of CHE, ALB and PA were detected using the automatic biochemistry analyzer. The patients were divided into 6 group according to the result of HCV-RNA levelHCV-RNA<103 kU/L group (group A, 52 cases), 103 kU/L≤HCV-RNA<104 kU/L group (group B, 77 cases), 104 kU/L≤HCV-RNA<105 kU/L group (group C, 81 cases), 105 kU/L≤HCV-RNA<106 kU/L group (group D, 92 cases), 106 kU/L≤HCV-RNA<107 kU/L group (group E, 87 cases) and HCV-RNA≥107 kU/L group (group F, 66 cases). Moreover, the patients were divided into 3 groups according to the result of serum CHE CHE normal group (> 5000 U/L, 321 cases), CHE mild abnormal group (4000- 5000 U/L, 56 cases) and CHE abnormal group (<4000 U/L, 78 cases). Results With the rising level of serum HCV-RNA from group A to group F, the serum levels of CHE, ALB and PA were all gradually decreased in hepatitis C patients, CHE (7288 ± 2817), (6316 ± 2341), (6103 ± 2596), (5208 ± 2222), (4282 ± 2173) and (3905 ± 1378) U/L; ALB (46.3 ± 9.9), (44.0 ± 8.4), (43.1 ± 7.6), (42.6 ± 7.1), (41.1 ± 5.4) and (39.3 ±5.1) g/L;PA(212.1 ± 67.8), (179.9 ± 72.8), (163.4 ± 57.5), (137.4 ± 60.3), (120.6 ± 45.0) and (112.5 ± 42.0) mg/L, and there were statistical differences (F=21.08, 6.08 and 27.54;P<0.01). With the decreasing level of serum CHE, the serum levels of ALB and PA were all gradually decreased, ALB(45.4 ± 10.1), (33.1 ± 4.2) and (31.5 ± 8.8) g/L;PA(209.3 ± 56.4), (108.4 ± 44.1) and (81.5 ± 49.6) mg/L, and there were statistical differences (F = 70.23 and 152.57, P<0.01). The bivariate Spearman correlation analysis result showed that the serum HCV-RNA level was negatively correlated with serum CHE, ALB and PA (r =-0.357, -0.326 and-0.471; P<0.05), and the serum CHE was positively correlated with serum ALB and PA (r=0.726 and 0.807, P<0.05). Conclusions The serum HCV-RNA level is closely related to liver function indices. Performing simultaneous detection of serum HCV-RNA level and serum PA is helpful in the early diagnosis and treatment of Hepatitis C.