乙型肝炎病毒滴度与血清标志物的关系

Corelation between HBV DNA,HBV markers and liver function

目的探讨乙型肝炎病毒的滴度与血清标志物及肝功能的关系。方法采用荧光定量聚合酶链反应(FQ-PCR)和ELISA法同时检测420份血清的HBV-DNA和血清标志物(HBV-M),并用全自动生化分析仪测定其肝功能ALT,对结果进行分析。结果105例HBsAg+、HBeAg+、HBcAb+组的血清HBV-DNA平均拷贝数为3.16×1010/m l,检出率为95.23%,显著高于其他组(P<0.01);HBsAg+、HBeAg+、HBcAb+组ALT异常率为64.76%(68/105),显著高于HBsAg+、HBeAb+、HBcAb+组ALT异常率36.96%(34/92)(P<0.01)。45例HBsAb+组血清HBV-DNA检出率为0,38例HBV-M全阴性组血清HBV-DNA检出率为7.89%。HBV-DNA阳性组ALT异常率为57.84%(107/185),显著高于HBV-DNA阴性组ALT异常率31.06%(73/235)(P<0.01)。结论定量PCR方法可以作为确认乙肝病毒感染不同状态的一种有效手段,血清标志物HBV-M阴性患者仍可有HBV-DNA阳性,HBV-DNA与HBV-M、肝功能同时检测,对乙肝的临床诊断、治疗方案的选择以及疗效判断有一定的指导意义。

To analyze the relationship between HBV-DNA, HBV markers and liver function of patients with hepatitis B. Methods 420 cases of viral hepatitis were tested by FQ-PCR and ELISA. And alanine aminotransferase （ALT） were determined by automatic biochemical analyzer. Results In 105 HBsAg ＋/HBeAg ＋/HBcAb ＋ Samples,the average lever of HBV-DNA was 3.16 × 10^10/ml with a positive rate of 95.23%. It was significantly higher than other groups （ P 〈 0. 01 ）. In HBsAg ＋/HBeAg ＋/HBcAb ＋ Samples,the positive rate of ALT was 64.76% （68/105）. It was significantly higher than HBsAg ＋/HBeAb ＋/HBcAb ＋ Samples with a positive rate （34/92） （ P 〈 0. 01 ）. 45 HBsAb ＋ cases were negative in HBV-DNA test. In 38 HBV-M negative cases,7.89% were positive in HBV-DNA test. In HBV-DNA positive group,the positive rate of ALT was 57.84%. It was sighnificantly higher than in HBV-DNA negative group with a positive rate of 31.06% （73/235） （ P 〈 0. 01 ）. Conclusions FQ-PCR can be used to be an effective method for reflecting the real situation of HBV infection. It was showed that HBV DNA could be positive even it may be negative for HBV-M. Detection of HBV-DNA, HBV-M and liver function are essential in diagnosis, treatment and assessment of curative effect of hepatitis B.