摘要
目的:测定慢性HBV感染不同状态时血清HBV-DNA水平,阐明其在判断病情和指导治疗中的价值。方法:共90例慢性HBV感染患者接受研究,共中HBeAg阳性无症状携带者(ASC)15例,HBeAg阳性慢性肝炎(CHB)17例,HBeAg阴性CHB14例,HBeAg阴性ASC16例;另有28例HBeAg阳性CHB接受干扰素治疗。血清HBV-DNA浓度测定应用AG-9600Amplisensor荧光PCR定量系统,测定范围定为10^(3.00-9.50)copies/ml。结果:血清HBV-DNA在HBeAg阳性ASC病例最高,达10^(8.46±0.71)copies/ml,其次依次为HBeAg阳性CHB(10^(7.24±0.54) cooies/ml)、HBeAg阴性CHB(10^(6.04±0.69) copies/ml),HBeAg阴性ASC者最低,为10^(3.80±0.71)copies/ml。4组病例相互之间差异在统计学上均有显著意义(P<0.01)。28例BHeAg阳性CHB患者接受干扰素治疗,治疗结束时呈完全应答(CR)者13例,无应答(NR)15例。对13例CR患者继续随访6个月,其中4例血清ALT再升高(复燃)。血清HBV-DNA水平在治疗前,CR不伴ALT复燃组HBV-DNA为10^(3.44±0.43)copies/ml,明显低于CR伴ALT复燃组(10^(6.84±0.51))(P<0.01)和NR组(10^(7.18±0.66))(P<0.01)。结论:测定血清HBV-DNA水平有助于鉴别慢性HBV感染的不同状态;在HBeAg阳性CHB病例,干扰素治疗结束时,检测HBV-DNA水平对于判断疗效有指导价值,HBV-DNA低于104copies/ml往往能取得持久疗效。
To measure serum hepatitis Bvirus (HBV)-DNA levels in various conditions of HBV infection, and to investigate its clinical significance for estimation of infection severity and determination of therapy. Methods: Serum HBVDNA conentration was measured in a toltal of 90 patients with chronic HBV infection, including 15 HBeAg-positive asymptomatic carries (ASCs), 17 HBeAg-positive chromic hepatitis (CHB), 14 HBeAg-negative CHB, and 16 HBeAg-negative ASCs, and 28 HBeAg-postivie CHB patients treated with interferon. -uantitiative analysis of HBV-DNA was by meas of AG-9600 Amplisensor fluorescence quatitiaive PCR system. The sensitivity ofthe assay was 10^(3-9.5) copies of genome/ml in serum. Results: Serum HBV-DNA levels was the highest in HBeAg-positive CHB (10^(8.46±0.71) copies/ml), followed by HBeAg-positive CHB (10^(7.24±0.54) copies/nk), HBeAg-negative CHB (10^(6.04±0.69) copies/ml), and HBeAg-negative ASCs (10^(3.80 ± 0.71) copies/ml) in order. Difference between above four HBV infection conditiotions ( p < 0.01 ) were considered statistically significant. Among patients received interferon, 13 cases had complete response (CR), and 15 no response (NR). Among 13 CR,a serum ALT flare-rp during 6 months after the end of treatment was observed in 4 patients. Before treatment, serum HBV-DNA in CR without ALT flare-up, CR with ALT flare-up and NR was similar. At the end of treatment, serum HBV-DNA in CR without ALT flare-up after treatment (103.44 ± 0.43 copies/ml) was significantly lower than that in CR with ALT flare-up (106.84 ± 0.51 copie/ml) (p < 0.01 ) and NR( 107.18 ± 0.66 copies/ml) (p < 0.01). Conclusions: Measurement of serum HBV-DNA levels is helpful for differentiation of various HBV infection conditions, and for prediction of interferon efficacy in HBeAg-positive chronic CHB patients as well, and a serum HBV-DNA below 104 copies/ml is an inportant marker for successful treatment
出处
《现代消化及介入诊疗》
1999年第2期23-25,共3页
Modern Interventional Diagnosis and Treatment in Gastroenterology
