乙肝患者血浆HBVDNA水平与乙肝五项指标关系分析

Correlations between HBV-DNA and HBV immunological markers in patients with chronic hepatitis B.

目的探讨乙型肝炎病毒核酸（HBV-DNA）水平与乙型肝炎免疫标志物五项指标之间的关系。方法回顾性分析来我院就诊的267例乙型肝炎患者的HBV-DNA含量与乙型肝炎免疫标记物（乙肝五项）的表达关系。患者血浆标本中HBV-DNA含量的检测采用实时荧光定量聚合酶链反应（FQ-PCR）,根据含量高低分为四个等级（小于103/ml、103-105/ml、105-107/ml、大于107/ml）;乙肝五项指标（HBsAg、抗HBsAb、HBeAg、抗HBeAb、抗HBcIgM）的检测采用酶联免疫法,按照阳性、阴性统计。结果乙肝患者血浆中HBV-DNA检出率为61.8%,HB-sAg、抗-HBsAb、HBeAg、抗-HBeAb、抗-HBcIgM的检出率分别为98.50%、1.12%、42.70%、40.45%、96.25%。在HBV-DNA含量不同的患者中,乙肝五项的检出率也不相同,随着HBV-DNA含量的升高,HBsAg、抗-HBcIgM的检出率变化不大,而HBeAg的检出率逐渐升高,抗-HBeAb检出率逐渐降低。结论血浆中HBVDNA含量与乙型肝炎免疫标志物之间存在密切的关系,随着HBV-DNA水平的升高,乙型肝炎免疫标志物出现不同的表达,这对临床医生更准确地判断患者病情及指导抗病毒药物的应用具有重要价值。

Objective： To study the correlations between HBV-DNA and hepatitis B virus （HBV） immunological markers in patients with chronic hepatitis B. Methods：In retrospect, analyses were made between HBV-DNA and HBV markers which were determined using fluorescent quantitative PCR and enzymelinked immunosorbent assay, respectively, in 267 patients with chronic hepatitis B. Results： In these patients, the HBV-DNA positivity rate was 61.8%, the positivity rates of HBsAg,anti-HBs, HBeAg, anti-HBeAb and anti-HBcAb were 98.50%, 1.12% ,42. 70% ,40. 45% and 96. 25% respectively. There were different positive rates of HBV immunological markers in patients with different HBV levels. The detection rates of HBeAg increased and the detection rates of anti-HBeAb decreased with the level of HBV-DNA while the positive rates of HBsAg and anti-HBcAb were not changed. Conclusion： These data sugest that there are close correlations between HBV-DNA and HBV immunological markers and detection of HBV markers and HBV-DNA may play an important role in assessing the status of viral replication and therapeutic efficacy in patients with chronic hepatitis B.