摘要目的:探讨乙型肝炎E抗原（HBeAg）阴性慢性乙型肝炎（CHB）患者血清中转化生长因子β1（TGF-β1）、单胺氧化酶（MAO）、透明质酸（HA）水平与乙型肝炎病毒DNA（HBV-DNA）载量的相关性，并研究联合检测TGF-β1、MAO、HA、HBV-DNA对HBeAg阴性CHB患者早期肝功能损害的临床意义。方法:选取2017年4月至2018年5月于南海经济开发区人民医院治疗的HBeAg阴性CHB患者128例作为试验组，男73例，女55例，年龄（33±14.6）岁；另外选取同期在南海经济开发区人民医院体检的100例健康体检者作为对照组，男56例，女44例，年龄（33±14.8）岁。根据HBV-DNA水平分成3组，HBV-DNA＞10 6拷贝/L为HBV高复制组，HBV-DNA在10 3～10 6拷贝/L为HBV中复制组，HBV-DNA＜10 3拷贝/L为低复制组，然后分别检测高、中、低3个复制组中的TGF-β1、MAO、HA水平，并作对比分析。 结果:试验组血清TGF-β1、MAO、HA、HBV-DNA水平及阳性率均高于对照组（均 P＜0.05）。不同HBV-DNA复制组间TGF-β1、MAO、HA水平比较，差异均有统计学意义（均 P＜0.05），且TGF-β1、MAO、HA水平均与HBV-DNA水平呈显著正相关，其中TGF-β1与HBV-DNA水平的相关性最高（ r=0.73）。联合检测TGF-β1、MAO、HA、HBV-DNA的诊断灵敏度为89.1%，特异度为72.7%，阳性预测值为76.5%，阴性预测值为87.0%，约登指数为0.62，其中灵敏度、阴性预测值、约登指数均比单独检测高，特异度低于单项检测。 结论:HBeAg阴性CHB患者血清中TGF-β1、MAO、HA水平与HBV-DNA载量具有很好的相关性，联合检测4项指标提高了HBeAg阴性CHB患者早期肝损害的检出率，有利于临床医生对HBeAg阴性CHB患者肝纤维化早期诊断，并为病情监测提供可靠的实验室依据。

abstractsObjective:To investigate the correlation of the serum levels of transforming growth factor-β1 (TGF-β1), monoamine oxidase (MAO), and hyaluronic acid (HA) with hepatitis B virus (HBV-DNA) load in patients with hepatitis B e antigen (HBeAg) negative chronic hepatitis B (CHB), and to study the clinical significance of the combined detection of TGF-β1, Mao, HA, and HBV-DNA for the early liver function damage of HBeAg negative CHB patients.Methods:One hundred and twenty-eight (33±14.6) years old patients with HBeAg negative CHB treated at People's Hospital of Nanhai Economic Development Zone from April 2017 to May 2018 were selected as an experimental group, including 73 males and 55 females. One hundred healthy (33±14.8) years old persons taking physical examination at People's Hospital of Nanhai Economic Development Zone during the same period were selected as a control group, including 56 males and 44 females. According to their HBV-DNA loads, the patients were divided into a HBV high replication group, whose HBV-DNA>10 6 copies/L, a HBV moderate replication group, whose HBV-DNA was 10 3-10 6 copies/L, and a HBV low replication group, whose HBV-DNA＜10 3 copies/L; the levels of TGF-β1, MAO, and HA in the 3 groups were detected, compared, and analyzed. Results:The levels of TGF - β 1, MAO, HA, and HBV-DNA and the positive rates in the experimental group were significantly higher than those in the control group (all P＜0.05). There were statistical differences in the levels of TGF-β1, MAO, and HA between the HBV high replication group, the HBV moderate replication group, and the HBV low replication group (all P＜0.05). The levels of TGF - β 1, MAO, and HA were positively correlated with HBV-DNA, and the correlation coefficient between TGF - β 1 and HBV-DNA was the highest ( r=0.73). The sensitivity, specificity, positive predictive value, negative predictive value, and Youden index of the combined detection of TGF-β1, MAO, HA, and HBV-DNA were 89.1%, 72.7%, 76.5%, 87.0%, and 0.62, respectively; among which, the negative predictive value and Youden index were higher than those of the single detections, and the specificity was lower than those of the single detections. Conclusions:The serum levels of TGF-β1, MAO, and HA correlate with HBV-DNA load in HBeAg negative patients. The combined detection of the four indicators can improve the detection rate of early liver damage in HBeAg negative CHB patients, which is helpful for clinicians to make early diagnosis of liver fibrosis in HBeAg negative CHB patients, and provide reliable laboratory basis for disease monitoring.