乙型肝炎病毒HBs、HBx基因与HBVM的相关性及临床意义研究

A RESEARCH IN CLINICAL SIGNIFICANCE OF AND RELATIONSHIP BETWEEN HBs AND HBx GENES AND HEPATITIS B VIRUS' MARKERS IN SERA OF PATIENTS WITH LIVER DISEASES

目的:阐明HB s、HBx基因与HBVM的相关性及临床意义。方法:以HCC s、LC ir、SeCH、CHB以及A SC s作为研究对象,应用EL ISA法检测研究对象血清中HB sA g、HB sA b、HB eA g、HB eA b、HB cA b;应用PCR技术、探针杂交法及免疫化学自显影法定性检测HB s、HBx基因。结果:在研究对象中,HB sA g+HB eA b+HB cA b、HB sA g+HB eA g+HB cA b和HB sA g+HB cA b模式阳性率分别为:53.3%、27.0%和11.8%;除A SC s组外,各临床类型肝病HB sA g+HB eA b+HB cA b模式阳性率均高于HB sA g+HB eA g+HB cA b模式的阳性率,但差别无统计学意义(P>0.05);与A SC s组比较,HCC s组的HBx基因阳性率明显高于A SC s组(P<0.05),其余各组均无明显差别(P>0.05)。与A SC s组比较,LC ir和SeCH组病人中的HB s基因阳性率显著高于A SC s组(P<0.025),其余各组无明显差异(P>0.05);以HB sA g模式作为对照时,各HBVM模式的HB s、HBx基因阳性率与HB sA g模式的阳性率无明显差别(P>0.05);但在HB sA g+HB eA g+HB cA b模式中阳性率显著高于HB sA g+HB eA b+HB cA b模式的阳性率(P<0.001);HB sA g+HB cA b模式中的HBx基因阳性率也显著高于HB sA g+HB eA b+HB cA b模式的阳性率(P<0.001)。结论:HB sA g+HB eA b+HB cA b模式与肝病的发病关系似乎比HB sA g+HB eA g+HB cA b模式更为密切;HBx基因与HCC s的发生存在密切关系,而HB s基因与LC ir、SeCH的发生关系密切。HB s、HBx基因与HB sA g+HB eA g+HB cA b模式关系密切,而HBx基因还与HB sA g+HB cA b模式存在密切关系。

Objective.In order to elucidate the clinical significance and the relationship between HBV DNA HBs, HBx genes and hepatitis B virus＇ markers in sera of patients with liver diseases, the investigation was carried on in our hospital. Methods. The subjects of the research were patients with primary hepatocellular carcinoma （HCCs）, liver cirrhosis （Lcir）, severe chronic hepatitis B （SeCH）, mild chronic hepatitis B （MiCH）, moderate chronic hepatitis B （MoCH）, heavy chronic hepatitis B （HeCH）, and asymptomatic carriers of HBsAg （ASCs）. Sera was collected from the subjects and the infectious markers of hepatitis B virus in sera （HBsAg, HBsAb, HBeAg, HBeAb, HBcAb） was examined with ELISA method, HBs and HBx genes were tested with polymerase chain reaction technology, and hybridization and immunofluoreseence autoradiography were probed. Result. The model of HBsAg ＋ HBeAb ＋ HBcAb was more commonly encountered than models of HBsAg＋HBeAg＋HBcAb and HBsAg＋HBAb, the positive rates of those models were 53.3%, 27.0% and 11.8% respectively in the liver diseases. The positive rate of HBsAg＋HBeAb＋HBeAb model was higher than HBsAg＋HBeAg＋HBcAb model in all kinds of liver diseases except ASCs patients, but without significance （P 2〉0.05）; The positive rate of HBx gene in group of patients with HCCs was significantly higher than that of ACSs （P 〈20. 05）, there was no difference between the remainder groups and ASCs group （ P 〉0.05） ; The positive rates of HBs in groups of patients with LCir and SeCH were significantly higher than that of group of patients with ASCs group （P 〈0. 025）; but there is no significant difference between the remainder groups and ASCs group （P 〉0.05）; No difference of positive rate of HBs and HBx genes was seen in comparing all the other HBVM groups with HBsAg group, but the positive rates of HBs and HBx gens in the model of HBsAg＋HBeAg＋ HBcAb were significantly higher than that of HBsAg ＋ HBeAb ＋ HBcAb model （ P 〈0. 001 ）;The positive rate of HBx gene in the HBsAg＋HBcAb model was significantly higher than that of HBsAg＋ HBeAb＋ HBeAb. Conclusion： There might be more significant relationship between model of HBsAg＋ HBeAb ＋ HBeAb and the development of liver diseases than that of HBsAg ＋ HBeAg ＋ HBcAb model. Significance of the relationship was seen between the development of HCCs and HBx genes HBs gene might relate to the development of SeCH and LCir~ There was close relationship between HBx, HBs genes and the model of HBsAg ＋ HBeAg ＋HBcAb, and the same relationship was seen between HBx gene and HBsAg ＋HbcAb model.