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手术干预前后HBsAg阳性患者HBV-DNA的变化及其临床意义

THE CHANGES AND SIGNIFICANCE OF SERUM HBV-DNA LEVEL IN HBsAg POSITIVE PATIENTS BEFORE AND AFTER OPERATION
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摘要 [目的]探讨HBsAg阳性患者经外科手术干预前后HBV-DNA的变化及临床意义。[方法]采用时间分辨免疫荧光分析法58例HBsAg阳性手术患者术前血清HBV-M,采用实时荧光定量PCR检测了HBsAg阳性手术患者术前和术后d3、d7血清HBV-DNA的变化情况。[结果](1)58例HBsAg阳性手术患者中27例血清中可检测到HBV-DNA,阳性率为46.1%,HBV-M的各种感染标志组合均有HBV-DNA检出。(2)27例检测到HBV-DNA的患者经外科手术干预后d3和d7,血清HBV-DNA拷贝数比术前显著增高(P﹤均0.01),另有4例术前感染标志组合表现为HBsAg、抗-HBe、抗-HBc阳性,但血清未检出HBV-DNA的患者,术后血清出现了104~106拷贝的HBV-DNA。[结论](1)各种感染标志组合的HBsAg阳性手术患者体内存在乙肝病毒的活动,外科手术的干预可引起病毒复制增强,临床应重视HBV-DNA的监测,进行必要的抗病毒治疗。 [Objective] To investigate the changes of serum HBV-DNA level in HBsAg positive patients before and after operation and its clinical significance. [Methods] HBV markers (HBV-M) in serum was detected in 58 HBsAg positive patients by time-resolved fluoroimmunometric assay before operation. HBV-DNA levels in serum of them in the 3rd, 7th day after operation were detected by real time fluoresent quantitative polymerase chain reaction. [ Results] HBV-DNA was detected out in 27 of 58 HBsAg positive patients and the positive rate was 46.1%. HBV-DNA was detected out in each type of HBV-M patients. After operation, serum HBV-DNA increased remarkably at the 3rd and the 7th day in these 27 patients (P 〈 0.01 ). Morover, there were 4 patients, whose serum HBV-M was HBsAg, HbeAb, HbcAb positive but without HBV-DNA detection before operation and with 104-106 copies of HBV-DNA after operation. [Conclusion] Hepatitis B virus can strongly replicate in I-IBsAg positive patients. Surgical interventions may promote the replication of HBV. It is necessary to monitor the quantity of virus and treat the patients with antiviral therapy.
作者 姚敏
出处 《现代预防医学》 CAS 北大核心 2007年第14期2763-2764,共2页 Modern Preventive Medicine
关键词 HBSAG 外科患者 HBV-DNA 手术干预 HBsAg Surgical patient HBV-DNA Surgical intervention
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