HBeAg阴性乙型肝炎患者血清乙型肝炎病毒DNA定量检测的临床意义

Clinical Significance of Quantitative Assay of HBV DNA in e-Antigen Negative Hepatitis B

目的 :了解 HBe Ag阴性慢性乙型肝炎 (乙肝 )血清乙肝病毒 (HBV) DNA含量及与临床的关系。方法 :用免疫荧光定量 PCR法检测 35 0例 HBe Ag阴性慢性乙肝 HBV DNA含量。结果 :HBV DNA总阳性率为 5 8% ,临床分型中 HBV携带者阳性率为 2 5 .6 % ,慢性活动性肝炎 (慢活肝 )、肝硬化及肝癌阳性率为 82 .8%～ 10 0 %。前者DNA含量为 10 ( 4.4 2± 1 .35) 拷贝 / m l,后三者为 10 5.2 5～ 10 5.88拷贝 / m l(P <0 .0 1) ,慢活肝又高于肝硬化及肝癌 (P <0 .0 5 ) ,阳性者血清丙氨酸转氨酶 <10 0 U / L者 DNA含量较低 (P <0 .0 5 )。结论 :HBe Ag阴性慢性乙肝多数仍存在病毒活动性复制 ,其病情活动程度与血清

Objective: To study the content of the serum hepatitis B viral DNA in e antigen negative hepatitis B and the clinical significance. Methods: The content of serum HBV DNA was assayed in 350 patients with HBeAg negative chronic hepatitis B through quantitative polymerase chain reaction (QPCR) based on immunofluorescence. Results:The total HBV DNA positive rate was 58%.That in asymptomatic HBsAg carriers (ASC) and those with chronic active hepatitis (CAH), liver cirrhosis (LC) and hepatcellular carcinoma (HCC) was 25.6% and 82.8%-100% respectively.The content of HBV DNA in ASC was 10 4.42±1.35 copies/ml,lower than that in the latter three types(10 5.25 to 10 5.88 copies/ml)(P<0.01 ), and that in CAH was higher than in LC and HCC (P<0.05). In HBV DNA positive patients, the content of DNA was lower in those with ALT<100 IU/L than in those with ALT>100 IU/L (P <0.05). Conclusion: There is active replication of HBV in the majority of patients with HBeAg negative CHB and the clinical development stage of hepatitis is related to the level of serum HBV DNA.