乙型肝炎病毒DNA含量与HBeAg、ALT相关分析及其临床意义

The correlation analysis between hepatitis B virus DNA and HBeAg and ALT and its clinical significance

目的 探讨乙型肝炎病毒HBV-DNA含量与血清标记物HBeAg、谷丙转氨酶（ALT）的相关性及其对肝病患者诊断、预后的意义.方法 采用酶联免疫吸附实验（ELISA）法检测523例乙肝患者血清学标记物（HBV-M）,其血清学模型包括以下四种组合,A组：HBsAg（＋）、HBeAg（＋）、HBcAb（＋）（大三阳）;B组：HBsAg（＋）、HBeAb（＋）、HBcAb（＋）（小三阳）;C组HBsAg（＋）、HBcAb（＋）;D组：HBsAb（＋）、HBeAb（＋）、HBcAb（＋）;并选取65例HBsAg（-）、HBsAb（-）HBeAg（-）、HBeAb（-）、HBcAb（＋）正常人（E组）作为对照.实时荧光定量PCR（FQ-PCR）检测血清中HBV-DNA含量,同时采用酶法测定血清ALT水平.结果 A组HBV-DNA阳性率为92.55%,明显高于B组78.97%（x2=189.60,P〈0.001）和C组50.98%（x2=234.15,P〈0.001）,A、D、C三组ALT水平均高于对照组（P〈0.001,P〈0.001,P〈0.001）;Log HBV-DNA与HBeAg S/CO之间存在正相关性（r=0.418,P〈0.001）,而ALT与Log HBV-DNA及HBeAg S/CO之间均无相关性.结论 HBV-DNA含量与乙肝病毒e抗原具有显著相关性,HBV-M和HBV-DNA定量检测并联合ALT水平对于临床乙肝病毒感染、复制及临床治疗有重要意义.

Objective To analyze the correlation of hepatitis B virus（HBV） DNA with hepatitis B e antigen and serum alanine aminotrans- ferase（ALT）, and to investigate their clinical signifcance in HBV diagnosis and prognosis. Methods 523 patients were enrolled in this study and divided into four groups according to the quantitative analysis of serum biomarker HBV- M by enzyme linked immunosorbent assay （ELISA）. Patients in group A： were tested positive for HBsAg, HBeAg and HBcAb; group B positive for HBsAg, HBeAb and HBcAb, group C was positive for both HBsAg and HBcAb, and group D with positive of HBsAb, HBeAb and HBcAb. Sixty - five patients with all HBsAg, HBsAb, HBeAg, HBeAb and HBcAb negative were enrolled as, control（group E）. Fluoroimmune quantitative PCR（FQ- PCR） was used to measure the levels of HBV DNA and ELISA for ALT detection. Results Positive rate of HBV - DNA in group A was 92.55 %, significantly higher than that of 78. 97 % in group B （X2 = 189.60, P 〈 0.001 ） and 50.98 % in group C （X2 = 234.15, P 〈 0.001 ）. The levels of ALT in group A, B and C were higher than those in control group（P 〈 O. 001 ）. There was a positive relationship between Log HBV - DNA and HBeAg S/CO, whereas no correlations were found between ALT and Log HBV - DNA or HBeAg S/CO. Conclusions There is significant correlation between the lerels of HBV - DNA and hepatitis B e antigen. Quantitative detection of both HBV- M and HBV- DNA combined with ALT may be available in the diagnosis of hepatitis B virus infection, republication and chnical treatment.