抗-HBe阳性慢性乙型肝炎患者中HBV—DNA检测与ALT的对比观察

Study on the relationship between the serum HBV - DAN and ALT with compared methods of the chronic Hepatitis B patients with positive anti - HBe

目的 探讨慢性乙型肝炎患者抗-HBe阳性患者中,乙型肝炎病毒核酸（HBV-DNA）含量与肝功能指标丙氨酸氨基转移酶（ALT）的相互关系及意义.方法 采用ELISA方法检测乙型肝炎表面标志物抗-HBe的表达;实时荧光定量聚合酶链反应（FQ-PCR）检测HBV-DNA含量;采用IFCC速率法检测ALT的水平.结果 抗-HBe阳性的患者中,HBV-DNA检测的阳性率为44.95%,ALT的阳性率31.65%,其中在HBV-DAN含量小于10^7 copy/ml的标本中,HBV-DNA定量检测与ALT呈正相关性（P〈0.05）.结论 临床上血清HBe阳性转为抗-HBe阳性后,并不说明HBV-DAN完全消除,若HBV-DNA持续阳性,并且HBV-DAN含量小于10^7 copy/ml,ALT持续增高时,肝功能损害会进一步加重,血清中HBV DNA含量与乙型肝炎免疫标志物以及肝细胞损伤三者之间存在密切的关系,在临床工作中应对血清HBV、ALT和HBV-DNA含量联合检测,这样才能更准确地判断患者病情、预后及指导抗病毒药物的应用.

Objective To investigate the relationship and significance of the serum concentration HBV - DNA and the marker of liver function（ALT） among the chronic Hepatitis B patients with positive anti - HBe. Methods ELISA had been used to detect the serum of anti - HBe ;the concentration HBW - DAN of was examined by the fluorescent quantitation PCR meter of MJ company ; the rate method of IFCC had been used to detect the serum ALT. Results Among the patient with positive anti - I4Be, the positive rate of HBV - DAN is 44.95% and the positive rate of ALT is 31.65 %, and when HBV - DNA 〈 10^7 copy/ml, it is positive correlated between the serum concentration HBV - DNA and the marker of liver function （ALT） （P 〈 0. 05 ）. Conclusion This study suggests that after the serum positive HBe converts the serum positive ant - HBe clinically, it dose not indicate the thorough clearance of HBV - DAN,if the positive HBV - DNA has been present and ALT continues to rise, and then the liver functional lesion will aggravate. Therefore, there is a certain correlation among HBV - DNA quantification, serum markers, and ALT. But the ALT cannot increase with the number of virus, and serum markers are not authentic markers that show the replication of HBV. It is necessary to examine them together.