慢性乙型肝炎患者血清HBsAg浓度与HBV DNA定量及HBeAg滴度的关系分析

Analysis of relationship between chronic patients with hepatitis B surface antigen concentration and HBV DNA quantitative analysis and E antigen titer

目的:定量检测慢性乙型肝炎(CHB)患者血清中乙肝病毒(HBV)表面抗原(HBs Ag)、e抗原(HBe Ag)浓度、HBV DNA、丙氨酸氨基转移酶(ALT)等4项指标,并探讨之间的关系。方法:收集437例CHB患者HBs Ag阳性血清,应用化学发光微粒子免疫分析法定量检测HBV血清学标志物和荧光定量聚合酶链反应检测HBV DNA载量。结果:将HBs Ag按浓度由低到高依次分为5组,并分别与HBV DNA、HBe Ag和ALT比较分析。统计结果显示,不同HBs Ag浓度组之间HBV DNA定量水平差异有显著性意义(F=119.753,P<0.01),组间两两分别比较,各组之间差异有显著性意义(P<0.01);不同HBs Ag浓度组间HBe Ag滴度的比较,差异有显著性意义(F=175.457,P<0.01),各组间两两比较,差异有显著性意义(P<0.01)。不同HBs Ag浓度组间ALT水平的比较,差异无统计学意义(F=2.545,P=0.056)。结论:HBs Ag在高浓度时(>10 000IU/ml)与HBV DNA的关联性较高,当HBs Ag浓度达到1 000IU/ml以上时与HBe Ag有较高的关联性,而HBs Ag浓度与血清ALT活性无关联性。所以在HBs Ag浓度下降后,坚持检测HBs Ag、HBV DNA及HBe Ag,将对治疗方案的调整和监测疗效提供更加全面的参考依据。

Objective： Quantitative detection of chronic hepatitis B patients with serum hepatitis B virus surface antigen（ HBs Ag）,the concentration of e antigen（ HBe Ag）,hepatitis B virus DNA（ HBV DNA）,alanine aminotransferase,and discuss the relationship between them. Methods： Collection serum of 437 cases of HBs Ag positive chronic hepatitis B patients,quantitative detection of HBV serological markers with luminous microparticle immunoassay and detection of HBV DNA load with fluorescence quantitative polymerase chain reaction.Results： All cases were divided into five groups by concentration of HBs Ag from low to high in turn,and were comparative analysis with HBV DNA,HBe Ag and ALT,statistics showed that the level of HBV DNA quantification between different HBs Ag concentrations there was a significant difference（ F = 119. 753,P 0. 01）,compared between all the two groups there are significant differences（ P 0. 01）; compared HBe Ag concentrations among different HBs Ag groups,there was a significant difference（ F = 175. 457,P 0. 01）,paired comparison among all groups,there was a significant difference（ P 0. 01）. Compared ALT levels between different HBs Ag groups,there was no significant difference（ F = 2. 545,P = 0. 056）. Conclusion： HBs Ag in high concentrations（ 10 000 IU / ml） showed higher relevance with HBV DNA,when the concentration of HBs Ag is 1 000 IU / ml or more there are higher relevance between HBs Ag and e antigen,there was not relevant with the concentration of HBs Ag and serum ALT activity. So after HBs Ag concentration decreased,detection of HBs Ag,HBV DNA and e antigen,will provide a more comprehensive reference for adjusting and monitoring curative effect on the treatment programs.