乙肝病毒血清标志物与其DNA检测结果对比分析及临床意义

Comparison and Clinical Significance of Quantitative Fluorescent Detection of HBV-DNA and the Results of Serum Marker

目的:比较乙肝血清不同模式标志物与HBV-DNA结果进行对比分析,探讨二者之间的关系及临床意义。方法:收集2012年8月-2013年3月乙肝患者标本548例,采用酶联免疫方法和实时荧光定量PCR方法分别检测乙肝病毒血清标记物和病毒DNA,比较它们之间的关系。结果:HBsAg阳性组共514例,HBV-DNA定量小于1×103copies/L(阴性)共244例,HBV-DNA定量大于1×103copies/L(阳性)共270例,HBV-DNA对数值为(5.31±1.74);HBsAg、HBeAg、HBcAb阳性组共118例,HBV-DNA对数值为(7.03±1.01);HBsAg、HBeAb、HBcAb阳性组共260例,HBV-DNA定量阳性共111例,其对数值为(4.21±1.20),HBV-DNA定量阴性共149例;HBsAg、HBcAb阳性组共116例,HBV-DNA定量阴性共70例,HBV-DNA定量阳性共46例,其对数值为(4.90±1.66);其他标志物模式组共34例,HBV-DNA定量阴性。HBV-DNA对数值在HBeAg阳性组与HBeAb阳性组间相比,有显著的统计学差异(P<0.05)。Real-time PCR法和ELISA法诊断乙肝的敏感性分别为49.3%和93.8%,符合率为55.5%。结论:Real-time PCR法和ELISA法在HBeAg阳性组有良好的相关性,两种方法分别检测乙肝病毒感染机体不同状态,它们之间能互为补充,不能相互替代。

Objective：To compare the results of quantitative fluorescent detection of HBV-DNA with the HBV serum marker and explore the relationship and clinical significance. Methods. 548 serum samples of HBV patients were collected from August 2012 to March 2013,all samples were detected by enzyme-linked immunosorbent assay（ELISA）and Real-time quantitative Polymerase Chain Reaction（Real-time PCR）at the same time, then the results of serum markers of hepatitis B virus and viral DNA were analyzed. Results：There were 514 patients in the group of HBsAg（ ＋ ）, the positive patients of HBV-DNA in the group of HBsAg（＋）were 270 and the average logarithmic value was（5.31± 1.74）. The patients in the group of HBsAg（＋）, HBeAg（＋）, HBcAb（＋）were 118 and the positive patients of HBV-DNA were 118, the average logarithmic value was（7. 03±1.01）. The patients in the group of HBsAg（＋）, HBeAb（＋）, HBcAh（＋） were 260 and the positive patients of HBV-DNA were 111, the average logarithmic value was（4. 21 ±1.20）. The patients in the group of HBsAg（＋）, HBcAb（ ＋ ） were 116 and the positive patients were 46, the average logarithmic value was（4. 90±1.66）. The patients of the other group were 34 and the quantitative detection of HBV- DNA was negative. The diagnostic sensitivity of Real-time PCR and ELISA was 49.3% and 93. 8% respectively, the coincidence rate of those two methods was 55. 5%. Conclusion.. There is a good correlation between Real-time PCR and ELISA,and the results of HBV patients detected by those two methods reflect the different states of hepatitis B infection. These two methods can complement each other and not substitute for each other.