乙型肝炎表面抗原及抗体同时阳性少见模式临床分析

The clinical analysis of both positive mode of HBsAg and HBsAb

目的探讨HBV感染者HBsAg与抗-HBs共存的不同模式,与HBV DNA、肝功能的关系。方法采用电化学发光法测定HBV标志物;采用荧光定量法检测HBV DNA含量;采用全自动生化分析仪检测肝功能。结果83例HBsAg与抗-HBs共存的患者中,HBsAg(+)HBsAb(+)HBeAg(+)HBcAb(+),HBsAg(+)HBsAb(+)HBeAg(+)HBeAb(+)HBcAb(+)与HBsAg(+)HBsAb(+)HBeAb(+)HBcAb(+)三组HBV-DNA检出率差异有统计学意义(χ2=6.469,P<0.05)。HBV-DNA阳性组肝功能5项指标与对应阴性组相比差异有统计学意义(P<0.05或P<0.01).将HBV-DNA含量与肝功能5项指标进行相关分析,P均大于0.05。结论HBV-M、HBV-DNA、肝功能反映疾病的不同方面,对于乙肝患者来讲三者结合能全面了解HBV感染、复制及传染性、肝损伤的程度,对诊断、治疗及疗效判断都很有价值。

Objective To explore the relationship between different concurrence modes of anti- HBs with HBsAg on the infection by hepatitis B viruses, HBV - DNA, and liver function.Methods HBV-M was detected by electro chemi luminescence immunity assay（ECL IA）. HBV-DNA was detected with fluorescent quantitative PCR （FQ-PCR） and Hepatic function was detected by an automatic biochemistry analyzer. Results The detecting rate of HBV-DNA had significant difference among the patients of HBsAg （ ＋ ）nSsAb（ ＋ ） HBeAg（ ＋ ）nScAb（ ＋ ）,HBsAg（ ＋ ）HSsAb（ ＋ ） HSeAg（ ＋ ） HBeAb（ ＋ ） HBcAb（ ＋ ） and nSsAg（ ＋ ） nBsAb （ ＋ ）HBeAb（ ＋ ）HBcAb（ ＋ ）（ Х^2= 6.469, P 〈 0.05）. Liver function had significant difference between HBV DNA（ ＋ ） group and HBV-DNA（ - ） group（ P 〈 0.05 or P 〈 0.01 ）. The correlation between HBV-DNA contents and liver function was analysed by SPSS. There was no correlationship between the HBV-DNA contents and liver function （ P 〉 0.05）. Conclusion So the detection of HBV-M, HBV DNA, and hver function could reflect the infection,replication of HBV and at the same time are valuable to diagnose, especially to assess the curative effect of patients with HBV.