荧光定量聚合酶链反应检测慢性乙肝患者HBV DNA的意义

The Clinical Significance of the Detection of HBV DNA in Patients with Chronic Hepatitis B by Fluorescence Quantitative Polymerase Chain Reaction

目的探讨荧光定量聚合酶链反应(FQ-PCR)检测慢性乙肝患者血清乙型肝炎病毒(HBV)脱氧核糖核苷酸(DNA)的临床意义。方法回顾性分析248例慢性乙肝患者的资料,均采用FQ-PCR技术检测血清HBV DNA,检测乙肝病毒标志物(HBV-M)并对比不同HBV-M患者血清HBV DNA水平;对比不同病情患者血清HBV DNA水平;对比不同HBV DNA表达患者外周血T淋巴细胞亚群水平及异常率,分析患者血清HBV DNA水平与外周血T淋巴细胞亚群水平的关系。结果不同HBV-M患者血清HBV DNA水平对比:HBsAg+HBeAg+HBcAb>HBsAg+HBeAg>HBsAg+HBsAb+HBcAb>HBsAg+HBeAb>HBsAb+HBeAb+HBcAb>HBcAb/HBsAb+HBeAb/HBeAb+HBcAb,除HBcAb、HBsAb+HBeAb、HBeAb+HBcAb血清HBV DNA水平差异无统计学意义(P>0.05),其余每2样本比较差异均有统计学意义(P<0.05);不同病情患者血清HBV DNA水平对比:重度病情患者>中度病情患者>轻度病情患者(P<0.05);不同HBV DNA表达患者CD3+、CD4+、CD4+/CD8+对比,HBV DNA阴性患者>低拷贝患者>高拷贝患者(P<0.05),CD3+、CD4+、CD4+/CD8+异常率对比,HBV DNA阴性患者<低拷贝患者<高拷贝患者(P<0.01);本组患者血清HBV DNA水平与外周血CD3+、CD4+、CD4+/CD8+均呈负相关(r=-0.789、-0.812、-0.706,P=0.012、0.007、0.001)。结论在慢性乙肝患者中FQ-PCR检测血清HBV DNA水平与HBV-M、病情和外周血T淋巴细胞亚群水平均有密切关系。

Objective To explore the clinical significance of fluorescence quantitative polymerase chain reaction(FQ-PCR)in the detection of serum HBV DNA among patients with chronic hepatitis B.Methods The clinical data of 248 patients with chronic hepatitis B were analyzed retrospectively.Serum HBV DNA and HBV-M were detected by FQ-PCR and HBV DNA level was compared among different HBV-M patients.The serum HBV DNA levels of patients with different disease status were also compared.Furthermore,the T lymphocyte subsets and abnormal rates in peripheral blood of patients with different HBV DNA expressions were compared.Lastly,the relationship between the level of serum HBV DNA and the level of peripheral blood T lymphocyte subsets was analyzed.Results Comparison of serum HBV DNA levels in different HBV-M patients showed results as:HBsAg+HBeAg+HBcAb>HBsAg+HBeAg>HBsAg+HBsAb+HBcAb>HBsAg+HBeAb>HBsAb+HBeAb+HBeAb+HBcAb>HBcAb/HBsAb+HBeAb/HBeAb+HBeAb.Among these comparisons,there were pairwise significant differences in serum HBV DNA levels(P<0.05),except for HBcAb,HBsAb+HBeAb and HBeAb+HBcAb(P>0.05).Comparison of serum HBV DNA levels in patients with different disease status showed results as:severe patients>moderate patients>mild patients(P<0.05).Comparison of CD3+,CD4+,CD4+/CD8+in different HBV DNA expression patients showed results as:HBV DNA negative patients>low copy patients>high copy patients(P<0.05).Comparison of abnormal rates of CD3+,CD4+,CD4+/CD8+in different HBV DNA expression patients showed results as:HBV DNA negative patients>low copy patients>high copy patients(P<0.01).The serum HBV DNA level was negatively correlated with CD3+,CD4+,and CD4+/CD8+(r=-0.789,-0.812,-0.706,P=0.012,0.007,0.001).Conclusion The detection of serum HBV DNA level by FQ-PCR is closely related to the level of HBV-M,disease condition and T lymphocyte subsets in peripheral blood.