乙型肝炎血清标志物定量检测在临床应用中的新角色

New role of quantitative detection of HBV serum markers in clinical application

确定HBV感染状态,评估预后及监测抗病毒疗效是乙型肝炎(乙肝)防治的核心内容,经典的乙肝五项定性检测已不能对上述临床实践提供有效支持;HBV DNA定量检测使乙肝实验诊断水平显著提高,但存在一定的局限。乙肝五项定量检测有可能弥补现有技术的不足,使HBV实验室检测更为全面和高效。临床研究表明,乙肝五项的定量指标与HBV感染自然史及肝纤维化进程存在相关性,在干扰素和核苷(酸)类似物的治疗中,其水平的变化不仅能反映治疗效果,还能较好地预测治疗终点,与HBV DNA定量联合使用有望形成完善的HBV感染临床管理体系。本文通过对相关内容进行综述,了解该领域的发展现状,以探讨其潜在的临床价值。

Determination of HBV infection status, assessment of disease prognosis and monitoring of anti-HBV therapy are key issues for the treatment and prevention of hepatitis B. The qualitative detection of the five serum markers of HBV can not provide clinicians with sufficient support for the clinical practice of HBV infection. Although the quantitative detection of HBV DNA has significantly improved the level of laboratory diagnosis of HBV, certain limitations remain. Quantitative detection of HBV serum markers may provide a potential complementary approach for laboratory diagnosis of HBV, therefore making the HBV testing more comprehensive and effective. Clinical studies have shown that the levels of HBV serum markers are correlated well with the natural history of HBV infection and the development of liver fibrosis. During the treatment with interferons and nucleos（t）ide analogues, the changes of the levels of the serum markers can not only indicate the therapeutic efficacy, but also predict the end point of anti-HBV treatment. Together with the quantitative detection of HBV DNA, the quantitative detection of HBV serum markers may form a complete system for the clinical management of HBV infection. This review focuses on the quantitative detection of HBV serum markers, so as to have an overlook on its development and investigate its potential significance in clinical application.