血清HBV-DNA与HBV标志物定量关系的探讨

Exploring the Relation between HBV-DNA and HBV-M

目的探讨乙型肝炎病毒DNA(HBV-DNA)含量与乙型肝炎血清免疫标志物(HBV-M)定量检测的相关性。方法对200例乙肝患者血清用实时荧光定量PCR(FQ-PCR)检测HBV-DNA,同时采用电化学发光免疫测定法(ECLIA)检测HBV-M含量,并对各项检测结果进行统计学分析。结果 HBV-DNA含量与HBeAg、HBeAb成正相关(r=0.537,r=0.531),与HBsAg成负相关(r=-0.456),与HBcAb无相关关系。乙肝患者在HBV-DNA不同含量分组(<103、103、104、105、≥106)中,随着HBV-DNA含量增加,HBsAg+/HBeAg+/HBcAb+(大三阳)患者HBsAg含量减少,HBeAg含量升高,当HBV-DNA>104时,HBeAg随着HBV-DNA增加而高水平维持,但没有显著性差异(P>0.05)。HBsAg+/HBeAb+/HBcAb+(小三阳)患者HB-sAg含量在同组间均比大三阳患者高,HBeAb含量变化与大三阳患者HBeAg变化相同。结论 HBV-DNA与HBeAg、HBeAb、HBsAg具有一定相关性,HBV-M定量检查可指示病人传染性强弱,但尚不是最可靠的指标,同时联合检测HBV-M和HBV-DNA可以对病情跟踪监测,为临床诊断和疗效观察提供依据。

Objective To explore the relation between the quantity of Hepatitis B virus DNA（HBV-DNA） and the HBV serum markers（HBV-M）.Methods In sera of 200 patients,HBV-DNA was detected by florescence quantitative PCR（FQ-PCR）,while HBV-M was detected by electrochemiluminescence immunoassay（ECLIA）.Results HBV DNA replication level was positively correlated with HBeAg,HBeAb concentration（r=0.537,r=0.531）,negatively correlated with HBsAg concentration（r=-0.456）,and unconnected with HBcAb.In the cases of HBsAg＋/HBeAg＋/HBcAb＋,the concentration of HBsAg decreased and HBeAg increased while HBV DNA content increased.When the HBV copies were more than 104/ml,HBeAg was still at a high level,but it had no significant difference with the HBV DNA content increasing.In the cases of HBsAg＋/HBeAb＋/HBcAb＋,HBsAg was higher than those of HBsAg＋/HBeAb＋/HBcAb＋ at the same HBV DNA level.And HBeAb had the same changes as HBeAg in HBsAg＋/HBeAb＋/HBcAb＋ patients.Conclusion There is a close relationship among HBV-DNA and HBeAb,HBeAg,HBsAg.HBV-M can indicate the strength of Hepatitis B infectious,but is not the most reliable indicators.It is more useful for clinical diagnosis,efficacy and prognosis by combined detection of both HBV-M and HBV-DNA.