磁珠法核酸提取对检测低HBV DNA病毒载量的临床价值

Clinical value of HBV-DNA detection with nucleic acid extraction of magnetic beads in patients with chronic hepatitis B of low viral loads

目的探讨两种核酸提取荧光定量PCR试剂在不同HBV DNA病毒载量时的临床应用价值。方法采用A试剂（煮沸法）和B试剂（磁珠法）检测264例慢性乙型肝炎患者血清标本的HBV DNA,对其结果进行统计学分析。结果两种试剂对于〈5×102 IU/ml样本的检测结果呈显著相关（R2=0.9438,P〈0.05）。对于≥5×102 IU/ml的样本,两种试剂检测结果差异无统计学意义（P〉0.05）;〈5×102 IU/ml组,两种试剂检验结果差异有统计学意义（P〈0.05）。对于A试剂检测结果低拷贝5×102~1×103 IU/ml组的19例样本,经B检测7例样本结果拷贝数升高至103~104IU/ml之间,19例样本B试剂检测结果对数值为（3.03±0.21）,高于A试剂检测结果的（2.55±0.05）,差异有统计学意义（t=4.23,P〈0.05）。结论在〈104 IU/ml拷贝样本中,B试剂核酸提取效率高于A试剂,从而更能反映病人体内的HBV DNA的病毒量,以指导临床用药。

Objective To investigate clinical application value of two real fluorescence quantitative PCR reagents for HBV-DNA determination in different viral loads. Methods 264 serum samples of patients with chronic hepatitis were detected for HBV DNA by the magnetic bead and boiling extracting reagents. Tested values were statistically analyzed.Results A significant correlation was observed between values tested by two HBV-DNA reagents for ≥5 ×102IU / ml samples（R2=0.9438 P〈0.05）.The difference was not statistically significant between the two groups of same viral loads for≥5×102IU / ml samples（P〉0.05）,and the difference was statistically significant between the two groups for 〈5×102IU /ml samples（P 〈0.05）. The tested logarithmic results were（2.55 ±0.05） and（3.03 ±0.21） with the two reagents for 5 ×102-1 ×103IU / ml samples and there was a significant difference（t =4.23 P 〈0.05）. Conclusions The tested results of magnetic beads reagent were higher than those boiling method reagent for 〈104IU / ml samples. Magnetic beads reagent can accurately detect HBV DNA in low DNA loads to guide the clinical medication.