HBV标志物定量与病毒载量关系探讨

Correlation of virus load to contents of serologic markers in HBV patients

目的研究乙型肝炎病毒各血清标志物含量与HBV-DNA含量的关系。方法采用时间分辨免疫荧光分析法(TRIFA)和实时荧光定量聚合酶链反应(FQ-PCR)分别测定1486例乙肝患者血清中乙型肝炎病毒抗原抗体定量和病毒含量。结果不同HBV标志物阳性模式的HBsAg定量存在显著差异,相同模式的HBsAg定量也差异极大。HBeAg(+)模式的HBV-DNA显著高于HBeAb(+)模式及HBeAg(-)HBeAb(-)模式(P<0.01),而后两者间无显著差异(P>0·05)。HBsAg、HBeAg含量与HBV DNA正相关(r值分别为0.383、0.635,P=0.01),HBeAb含量与HBV DNA负相关(r=-0.563,P=0.01)。HBsAg定量与HBeAg定量正相关(r=0.466,P=0.01),与HBeAb定量负相关(r=-0·524,P=0·01)。结论HBV标志物定量之间及与HBV DNA含量间存在一定相关性,但个体差异极大。全面了解HBV标志物含量及HBV DNA定量可更准确判断病毒复制、状态,为临床决策提供可靠依据。

Objective To explore the relationship between HBV load and the contents of serologic markers. Methods Time-resolved immunofluorometric assay （TRIFA） was used to detect the contents of HBV immunological markers and real-time fluorescent quantitative PCR （FQ-PCR） was used to measure the HBV DNA of 1 486 clinical serum samples. The data was analyzed by SPSS11.0. Results The HBsAg contents were extremely different in the same or different models of serologic markers. The HBV copies of HBeAg（ ＋ ） patients were significantly more than HBeAb（ ＋ ） and HBeAg（ - ）HBeAb（ - ） patients （P 〈0.01 ）, but without statistical significance between HBeAb（ ＋ ） and HBeAg（ - ）HBeAb（ - ） patients （P 〉 0.05 ）. The contents of both HBsAg and HBeAg were positively correlated with the load of HBV DNA （ r = 0. 383, 0. 635, P = 0.01 ）, while HBeAb negatively correlated to it （r = -0. 563, P = 0.01 ）. Direct correlation existed between the contents of HBsAg and HbeAg （r =0. 466, P = 0.01 ） while inverse correlation was observed between the contents of HBsAg and HbeAb （ r = - 0. 524, P = 0.01 ）. Conclusion A certain correlation exists between the contents of serologic markers and DNA of hepatitis B but the great variance exists among individuals. Combining FQ-PCR with TRIFA method is profitable for judging the state of HBV viral replication roundly and provides scientific and reliable evidences for clinical decisions.