联合检测血清标志物、ALT和HBV-DNA对乙型肝炎患者诊疗的临床意义

The clinical significance of serum markers,ALT and HBV-DNA in patients with hepatitisclinical significance

目的通过联合检测乙型肝炎血清标志物、ALT和HBV-DNA,分析三者之间的相关性。方法分别采用ELISA、实时荧光定量聚合酶链反应(FQ-PCR)和IFCC双试剂酶法对682例乙型肝炎患者HBV血清标志物(HBsAg、HB-sAb、HBeAg、HBeAb、HBcAb)、HBV-DNA载量和ALT水平进行测定。结果 682例乙型肝炎患者中,有373例检测出HBV-DNA阳性,阳性率为54.69%;以模式Ⅰ组(HBsAg+HBeAg+HBcAb阳性)和模式Ⅱ组(HBsAg+HBeAg阳性)HBV-DNA阳性率和平均载量为最高,且明显高于模式Ⅲ(HBsAg+HBcAb阳性)、模式Ⅳ组(HBsAg+HBeAb+HBcAb阳性)和模式Ⅴ组(HBcAb阳性)(P<0.05);模式Ⅰ组ALT阳性率、平均含量明显高于其它组(P<0.01)。在HBV-DNA阳性患者中,HBV-DNA载量与ALT水平呈正相关。结论 HBV-DNA载量与血清标志物以及ALT水平之间存在着一定的关系,但三者反映的是疾病的不同方面。在HBV感染的诊疗过程中,联合检测血清标志物、HBV-DNA载量和ALT水平,在判断病情转归、抗病毒疗效观察等方面具有重要意义。

Objective By combined detection of hepatitis B virus serum markers, ALT and HBV-DNA to analyze the cor- relation of the three. Methods Using ELISA, fluorescence quantitative polymerase chain reaction （FQ-PCR） and IFCC double reagent enzymatic method to detect HBV serum markers （HBsAg, HBsAb, HBeAg, HBeAb, HBcAh）, HBV-DNA load and ALT level in 682 cases of patients with hepatitis B. Results In the 682 cases of hepatitis B patients, 373 cases HBV-DNA were posi- tive, the positive rate was 54. 69%. In the model Ⅰ group （ HBsAg ＋ HBeAg ＋ HBcAb positive） and model Ⅱ group （ HBsAg ＋ HBeAg positive） the positive rate of HBV-DNA and the average load was the highest, and was significantly higher than the modeⅢ （HBsAg ＋ HBcAb positive）, model group Ⅳ （HBsAg ＋ HBeAb ＋ HBcAb positive） and model group V （HBcAb positive） （ P 〈0.05 ）. Pattern of group I （ HBsAg ＋ HBeAg ＋ HBcAb positive） the positive rate of ALT, the average content of were signif- icantly higher than other groups （P 〈 0. 01 ）. In HBV-DNA positive patients, HBV-DNA load and ALT level positively correlated. Conclusion There is a certain relationship between HBV-DNA load , serum markers and ALl＇ level, but the three is reflected in the different aspects of the disease. In the process of diagnosis and treatment of HBV, joint detection of serum markers, HBV-DNA load and ALT level,which has the vital significance in the judgement of prognosis and antiviral efficacy.