慢性乙型肝炎患者抗病毒疗效监测中高灵敏荧光定量PCR技术的应用

Application of high sensitive fluorescent quantitative PCR in monitoring antiviral efficacy of patients with chronic hepatitis B

目的分析高灵敏度荧光定量PCR技术与普通荧光定量PCR技术在慢性乙型肝炎(CHB)患者抗病毒疗效监测的价值。方法分析2018年7月-2019年10月武威肿瘤医院收治的122例CHB患者,其普通PCR检测结果阴性,采用高敏PCR试剂进行复查,分析高敏PCR检测与普通PCR检测的差异。结果122例普通PCR检测结果阴性的CHB患者中,采用高敏PCR进行复查显示:血清HBV-DNA存在>500、20~、10~、<10、阴性5种情况,其比例分别为13.11%、32.79%、18.03%、31.97%、4.10%。据克鲁斯卡尔-沃利斯HK检验分析结果显示:CHB患者不同HBVDNA表达情况患者肝功能指标丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)水平之间,差异无统计学意义(x^(2)=3.468、6.631,P=0.483、0.157);HBeAg及HBe水平之间,差异无统计学意义(x^(2)=8.804、1.303,P=0.089、0.861)。结论与普通PCR相比,高敏感度的HBV荧光定量PCR技术,对CHB患者治疗期间病毒载量的检测更加准确。

Objective To analyze the value of high sensitivity fluorescent quantitative PCR(FQ-PCR)and conventional FQPCR in monitoring the antiviral efficacy of patients with chronic hepatitis B(CHB).Methods 122 CHB patients in our hospital from July 2018 to October 2019 were analyzed.The results of ordinary PCR were negative,and the high-sensitivity PCR reagent was used for recheck,and the difference between high-sensitivity PCR detection and ordinary PCR detection was analyzed.Results Among 122 CHB patients with negative results of ordinary PCR,re-examination using high-sensitivity PCR showed that there were 5 types of serum HBV-DAN:>500,20-,10-,<10,and negative;the proportions of which were 13.11%,32.79%,18.03%,31.97%and 4.10%respectively.According to the analysis of Kruskal-Wallis HK test,there was no significant difference between the liver function indexes alanine aminotransferase(ALT)and aspartate aminotransferase(AST)levels of patients with different HBV-DNA expression in CHB patients(x^(2)=3.468,6.631,P=0.483,0.157).There was no significant difference between HBeAg and HBe levels(x^(2)=8.804,1.303,P=0.089,0.861).Conclusion Compared with ordinary PCR,the highly sensitive fluorescent quantitative PCR technology was more accurate in detecting viral load of CHB patients during treatment.