慢性乙型肝炎肝内炎症与HBV-DNA定量的关系

Relation of serum HBV-DNA level to intrahepatic inflammation in patients with hepatitis B

目的 探讨慢性乙型肝炎肝内炎症与 HBV-DNA定量的关系 ,为临床正确估计肝内炎症提供依据。方法 应用荧光定量PCR法检测 74例慢性乙肝患者血清中 HBV-DNA的含量 ,同时行肝穿刺病理检查。结果 在 HBs Ag阳性患者中 ,HBV-DNA的水平与 Scheuer分级无相关性 ,提示 HBV-DNA的含量与肝内炎症活动程度无关。但是 ,在 HBe Ab阳性患者有相关性 ,HBe Ag阳性者中则无。结论 慢性乙型肝炎患者 ,如果不是在免疫耐受期 ,HBV-DNA复制水平与肝内炎症活动程度是相关的。由于 HBV-DNA复制水平的增高先于 ALT升高 ,检测 HBV-DNA含量可能更有助于选择治疗的时机。

Objective To study the correlation of serum HBV DNA level with intrahepatic inflammation in patients with hepatitis B.Methods Quantitative PCR of fluorimetry was applied to the determination of HBV DNA level in the serum of 74 cases of CHB and at the same time pathological examination was performed through liver puncture. Results There are relations between serum HBV DNA level and Scheuer's grading in patients with HBeAb positive,but not in patients with HBeAg,suggesting that the HBV DNA level is not related with the degree of intrahepatic inflammation.Conclusion CHB patients,if not under immunotolerance,have their HBV DNA level correlated with the activity of intrahepatic inflammation.Since HBV DNA is raised before the rising of ALT,assaying the serum HBV DNA level may contribute to the choice of the time of the treatment.