慢性乙型肝炎患者血清HBsAg定量检测及其临床意义

Quantitative analysis of serum HBsAg in patients with chronic hepatitis B and its clinical significance

目的定量检测慢性乙型肝炎(CHB)患者血清HBsAg和HBV DNA水平并分析其相互关系,探讨定量检测HBsAg的临床应用价值。方法选取HBeAg阳性CHB患者41例,HBeAg阴性CHB患者29例,采用全自动生化仪检测丙氨酸氨基转移酶(ALT)等生化指标,采用化学发光分析仪定量检测血清HBsAg滴度,采用PCR仪检测血清HBV DNA载量。结果 HBeAg阳性CHB患者血清HBsAg滴度略高于HBeAg阴性患者(P=0.064),两组患者HBsAg/HBV DNA比值差异无统计学意义。CHB患者血清HBsAg与HBV DNA总体相关(P=0.002),随着HBV DNA载量上升,血清HBsAg也明显上升(χ2=6.989,P=0.002);HBeAg阳性患者血清HBsAg与HBV DNA水平呈正相关(r=0.383,P=0.015),而HBeAg阴性患者HBsAg与HBV DNA无相关性。结论血清HBsAg与HBV DNA总体相关,但在HBeAg不同状态患者血清中HBsAg滴度及其与HBV DNA的相关性差异均有统计学意义,这些发现对于将HBsAg定量检测作为临床指标具有实际意义。

Objective To study the level of HBsAg,HBV DNA and the correlation with HBeAg in the sera of patients with chronic hepatitis B（CHB）.Methods Fourty-one HBeAg-positive（＋） CHB patients and 29 HBeAg-negative（-） CHB patients were recruited.HBsAg and HBeAg titers were detected by chemiluminescence immunoassay analyzer,and the level of HBV DNA was detrmined by real-time fluorescence quantitative polymerase chain reaction（PCR）.Results HBsAg titers in HBeAg（＋） CHB patients were slightly higher than that in HBeAg（-） CHB patients[（3.735±0.932）lg IU/ml vs（3.301±0.852）lg IU/ml,P=0.064];while there was no significant difference in the ratio of HBsAg∶HBV DNA between the two groups（P0.05）.Overall,the serum HBsAg titer showed positive correlation with HBV DNA level（χ2=6.989,P=0.002）.Within the HBeAg（＋） group,HBsAg was positively correlated with HBV DNA levels（r=0.383,P=0.015）.There were no significant correlations between HBsAg,HBeAg and HBV DNA in HBeAg（-） CHB group.Conclusions The serum HBsAg titers are positively correlated with HBeAg and HBV DNA.Quantitative HBsAg analysis might be used to reflect the clinical status of CHB.