650例慢性乙肝患者HBV-M、HBV-DNA同步检测分析

Analysis on synchronous test of HBV-M and HBV-DNA in 650 patients with chronic hepatitis

目的探讨HBV-M、HBV-DNA联合检测模式在乙肝患者中的应用价值。方法回顾性分析我院于2011年5月-2012年5月收治的650例慢性乙肝患者同时进行的HBV血清学检测(采用CMIA方法,化学发光微粒免疫测定)和DNA检测(采用PCR方法,聚合酶链反应)的结果。结果慢性乙肝血清学标志物常见模式8种,占总体的98.5%;罕见模式3种,合计占总体的1.5%。所有血清学模式对应的PCR阳性率为0～100%不等,以HBsAg、HBeAg和HBsAg、HBeAb 2种模式对应的阳性率为最高,均为100%。阳性PCR患者中,DNA拷贝数最高的2种血清学模式为HBsAg、HBeAb、HBcAb(7.36×107,cope/mL)和HBsAg、HBeAg(5.49×107,cope/mL)。HBeAg与DNA复制情况联系最为紧密,两种检测一致率超过80%。结论血清学模式与DNA复制情况一致性与临床经验一致,应用CMIA和PCR法进行同步HBV-M和HBV-DNA联合检测可有效弥补各自不足,对慢性乙肝患者病情的综合判断和长期管理具有重要价值。期待未来进一步前瞻性和扩大样本量研究结果。

Objective To analyze the synchronous test results of HBV-M and HBV-DNA in 650 patients with chronic hepatitis, and to explore the application value of this test model. Methods The test results of HBV-M （using CMIA） and HBV-DNA （using PCR）in 650 patients with chronic hepatitis recruited from our hospital from May. 2011 to May. 2012 were analysised retrospectively. Results 8 common models and 3 rare models of HBV-M were found out, with patients amount ratio 98.5% and 1.5% , respectively. All models held PCR positive rates ranging from 0 to 100% and 100% for the model of positive HBsAg ＆ HBeAg and HBsAg ＆ HBeAb. Among the positive PCR patients, models of HBsAg ＆ HBeAb ＆ HBcAb（7.36 × 10^7, cope/mL）and HBsAg ＆ HBeAg were （5.49 × 10^7, cope/mL）were with the highest DNA cope numbers. Result of HBeAg was closely connected to that of DNA and the concordance rate was over 80%. Conclusion The results of HBV-M and HBV-DNA concordance is similar to the clinical experience and synchronous test of both using CMIA and PCR could perfect each other in better comprehensive disease condition judgment and long term management. Look forward to future perspective and enlarged recruitment research.