慢性乙型肝炎患者血清HBeAg与病毒含量及BCP变异关系的临床研究

A STUDY ON THE RELATIONSHIP BETWEEN SERUM HBeAg AND HBV DNA CONTENTS AND BCP MUTATION IN PATENTS WITH CHRONIC HEPATITIS B VIRUS INFECTION

目的 :探讨慢性乙型肝炎患者血清 HBe Ag与病毒含量及 BCP变异的关系。方法 :分别用定量聚合酶链反应法 (PCR)和酶标法 (EL ISA) ,检测 2 0 7例乙型肝炎病毒慢性感染者血清 HBV DNA含量与乙肝病毒血清标记物 (HBVM) ;其中 74例乙型肝炎病毒慢性感染者采用 PCR微板核酸杂交结合 EL ISA检测显示技术 ,检测 BCP区核苷酸 (nt) 176 2碱基 A→ T和 176 4碱基 G→ A联合突变。结果 :HBe Ag阳性组与 HBe Ag阴性组血清 HBV DNA含量分别为 10 7.4 0 70± 2 .3830和 10 5.0 797± 3.5389拷贝 /ml,两组相比差异有统计学意义 (P <0 .0 0 1)。在 74例乙型肝炎病毒慢性感染者中检出 BCP区 T176 2 A176 4突变 2 4例(32 .4 % ) ,BCP变异在 HBe Ag阴性病例的发生率为 4 2 .9% (18/4 2 ) ,显著高于 HBe Ag阳性病例 18.7% (6 /32 ) (P <0 .0 5 )。结论 :HBe Ag阳性是乙型肝炎病毒体内复制的指标 ;但 HBe Ag阴性不能认为乙型肝炎病毒复制停止 ,定量 HBV DNA可以真实反映 HBV感染、复制的情况。

Objective:To investigate the relationship between HBV DNA quantity and e system in patients with chronic hepatitis B virus infection.Methods:HBV DNA quantity was detected by PCR and HBVM was detected by ELISA in 207 patients with chronic hepatitis B virus infection. Combining polymerase chain reaction with ELISA, mutants (nt1762A →T and 1764G→A) of HBV BCP in 74 out of 207 patients with chronic hepatitis B virus infection were studied.Result:The quantity of HBV DNA in HBeAg positive group(10 7.407 0±2.383 0 copy/ml) was significantly higher than that in HBeAg negative group(10 5.079 7±3.538 9 copy/ml) (P<0.001). The T1762 and A1764 mutants in HBV BCP region was founded in 24 (24/74) patients with chronic HBV infection.The rate of HBV BCP mutants in negative and positive groups of HBeAg was 42.9%(18/34) and 18.7% (6/32) respectively (P<0.05).Conclusion:HBeAg positive could be considered as a marker for HBV replication; but HBeAg negative did not suggest the cease of HBV DNA replication ,Quantitative PCR can reflect the true state of HBV infection and replication.