HBsAg定量与HBV-DNA联合检测在慢性乙型肝炎中的临床意义

Clinical Significance of Combined Detection of HBs Ag and HBV-DNA in Patients with Chronic Hepatitis B

目的探讨慢性乙型肝炎病毒(HBV)感染患者表面抗原定量检测与HBV-DNA相关性,并探讨其检测临床意义。方法检测2010年12月至2012年12月200例未接受抗病毒治疗及免疫调节剂治疗的慢性HBV感染患者治疗前、治疗中HBsAg与HBV-DNA水平,并随访20例治疗后HBV-DNA转阴患者HBsAg与HBV-DNA水平变化,探究HBsAg定量检测临床意义。结果慢性乙型肝炎患者未接受抗病毒治疗及免疫调节剂治疗前HBe Ag(+)患者HBsAg与HBV-DNA水平显著正相关(r=0.683,P<0.05),HBe Ag(-)患者两者正相关性,但相关性较低(r=0.273,P<0.05)。治疗过程中HBsAg与HBV-DNA水平呈正相关(r=0.41,P<0.01),65.5%(131/200)的变化规律为HBsAg随HBV-DNA含量的下降而下降。20例HBV-DNA治疗后转阴(HBV-DNA<500拷贝/m L)患者,其中6例治疗期间HBsAg定量持续下降,HBsAg定量均<250IU/m L,停药后24周复检HBV-DNA仍为阴性。14例治疗后乙肝病毒定量转阴患者(HBV-DNA<500拷贝/m L),治疗期间HBsAg定量不降或上升,停药后24周复检病毒定量有4例(4/14)出现反弹(HBV-DNA>500拷贝/m L)。结论血清HBsAg含量与HBV-DNA具有相关性,临床可将HBsAg含量与HBV-DNA联合检测,用于慢性HBV感染患者的病情程度预判,监测临床治疗疗效。

Objective To explore the clinical significance of combined detection of HBsAg and HBV-DNA in patients with chronic Hepatitis B. Methods 200 cases of chronic Hepatitis B patients without antiviral and immunomodulatory treatment was selected in this study. The HBsAg and HBV-DNA levels in patients before and after treatment were detected and followed up 20 cases patient with HBV-DNA changed to negative. Results The levels of HBsAg in chronic Hepatitis B patients without antiviral and immunomodulatory treatment was significantly positively correlated with the level of HBV- DNA （ P 〈 0.05 ）. In the process of treatment, the HBsAg levels were decrease with HBV-DNA content decrease. The HBV-DNA in 20 cases of patients was changed to negative after treatment, and the HBsAg levels in 6 cases continued to decline and still keep negative at 24 weeks after stopping treatment. Conclusion There is some extent correlation between serum HBsAg and HBV-DNA in patients with chronic Hepatitis B. The combined detection of HBsAg with HBV-DNA could be can be used for forecasting the condition of patients and monitoring the treatment effect in chronic Hepatitis B patients.