乙型肝炎病毒学检验结果分析

The virology test result analysis of hepatitis B virus

目的 了解乙型肝炎病毒（HBV）病毒学检测特点,探讨HBV基因分型与HBeAg、抗-HBc-IgM、HBV DNA及疾病进展的关系.方法 采用ELISA法检测深圳地区200例乙型病毒性肝炎患者的两对半标志物（HBsAg,抗-HBs,HBeAg,抗-HBe,抗-HBc）及抗-HBc-IgM,采用荧光定量聚合酶链反应（FQ-PCR）法进行HBV DNA定量检测,用单克隆抗体ELISA法进行HBV基因分型,并对检验结果 进行分析.结果 在200例乙型病毒性肝炎患者中测定出HBV基因分型179例（89.5%）,B型121例（60.5%）,C型58例（29.0%）.HBeAg、抗-HBc-IgM、HBV DNA与基因分型无关.B型多见于无症状HBsAg携带者及慢性乙型病毒性肝炎患者;C型多见于肝硬化及慢性乙型病毒性肝炎患者.结论 深圳地区HBV基因分型以B型为主,C型次之.单克隆抗体ELISA法检测HBV基因分型具有特异、敏感、简单和实用的特点,HBV复制强弱与病毒基因分型无关.HBV基因分型与HBeAg、抗-HBc-IgM、HBV DNA检验可相互补充,具有临床应用价值.

Objective To understand the virology test characteristics of hepatitis B virus （HBV） for discuss the relation of HBV genotype and HBeAg, anti-HBc-IgM, HBV DNA and disease progression. Methods Two hundred cases of hepatitis B were detected by the ELJSA assay with two pairs of semi-markers （HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBc） and anti-HBc-IgM, using fluorescence quantitative polymerase chain reaction （FQ-PCR） for detecting HBV DNA, using monoclonal antibody ELISA method （mAbs ELISA） for HBV genotyping and analysis of test results. Results In 200 patients with hepatitis B, the HBV genotype detected in 179 cases （89.5%）, B-type 121 cases（60.5%）, C-type 58 cases （29.0% ）. There had no relationship with HBeAg, anti-HBc-IgM, HBV DNA and genotype. B-type HBV prevalent in asymptomatic carriers （ASC） and chronic hepatitis B （mild）;C-type common in patients with liver cirrhosis （LC） and chronic hepatitis B （severe）. Conclusions HBV genotype in Shenzhen mainly is B-type, C-type second;mAbs ELISA assay with HBV genotype is specific, sensitive, simple and practical features, HBV replication strength has nothing to do with the virus genotype. HBV genotype and HBeAg, anti-HBc-IgM, HBV DNA testing may complement each other, with the clinical application value.