乙型肝炎病毒DNA与血清标志物的关系

Relation between virus serum markers and nucleic acid of hepatitis B virus

目的探讨乙型肝炎(下称乙肝)免疫标志物(HBV-M)两对半模式与乙肝病毒核酸(HBV DNA)阳性率及复制水平之间的关系和临床意义。方法乙肝患者血清分别采用酶联免疫吸附试验(ELISA)检测乙肝两对半免疫指标(HBsAg、抗-HBs、HBeAg、抗-HBe、抗-HBc),实时荧光定量-聚合酶链反应(FQ-PCR)检测HBV DNA含量,并对结果进行对比分析。结果在HBV-M不同模式中,HBV DNA的阳性率不同,HBV DNA含量也不相同;在HBV-M中HBeAg阳性与HBV DNA检出率呈正相关。以HBsAg(+)HBeAg(+)抗-HBc(+)组(大三阳组)HBV DNA的阳性率最高,病毒载量较高。结论不同HBV-M具有不同的临床意义,而HBV DNA是衡量乙肝传染性的最精确指标,是确定HBV感染不同复制状态的检测手段,HBV DNA阳性表明有完整的病毒颗粒复制,即有传染性。因此,联合检测HBV-M和HBV DNA,不仅可以提高检出率,避免漏诊,而且为临床对HBV感染、复制、传染性判定以及抗病毒治疗的疗效评估提供了更为可靠的判定依据。

Objective To discuss the connection between immunity markers of hepatitis B virus serum markers （HBV-M） and the positive rate and duplication of HBV DNA and its clinical meaning. Methods To detect the immunity markers of HBVM（HBsAg. HBsAb,HBeAg, HBeAb. HBcAb） with ELISA and DNA content of HBV with FQ-PCR in order to do contrast analysis. Results If the HBV M was different,the positive rate of HBV DNA was also different,the content of HBV DNA was also different;the positive rate of HBeAg had positive correlation with the detection rate of HBV DNA. The positive rate of HBsAg, HBeAg, HBcAb was the highest, the content of virus was the most, Conclusion Different HBV-M has different clinical meaning, so HBV DNA is the most accurate index, which can help to confirm the virus reproducing level by this measure method. The positive HBV DNA can reflect if the patient has an intact virus reproducing cycle, the hepatitis virus must be infective. So, combination detection of HBV-M and HBV DNA can enhance the detection rate to avoid missed diagnosis and help to determine the infection and reproduction of HBV,moreover it can offer a credible proof to evaluate therapy effect of antiviral therapy.