超敏系统检测低拷贝HBVDNA定量的临床意义

To investigate the clinical significance of detection of low copy HBV-DNA with hypersensitive quantitative system

目的探讨超敏HBV DNA定量检测的低拷贝结果与HBV标志物和肝功能主要指标的相关性。方法同时检测283例HBV DNA≤1 000IU/mL低拷贝的乙型肝炎患者的5项肝功能指标,并进行组间比较。结果乙型肝炎病毒定量低拷贝的患者HBV标志物中HBV e抗原(HBeAg)差异有统计学意义(χ~2=5.310,P=0.021);HBVe抗体(HBeAb)差异无统计学意义(χ~2=1.266,P>0.05);126例小三阳患者中,HBV DNA定量结果在20及20~10~3 IU/mL 55.56%;117例大三阳患者中,HBV DNA定量检测结果阴性21.37%;肝功能指标谷氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、碱性磷酸酶(ALP)异常率分别为15.90%、8.13%、13.78%。结论乙型肝炎5项定量结果低或经抗病毒治疗后的患者,临床应采用超敏系统检测HBV DNA定量,同时结合乙型肝炎5项定量与肝功能,更好地了解病毒复制情况和肝细胞损害程度,为治疗提供可靠的临床依据。

Objective Analysis of the relationship of low copy HBV-DNA results using hypersensitive quantitative system and HBV markers or liver function indexes,and investigate the clinical application value.Methods Hepatitis B virus antigens and antibodies and liver function indexes were detected in the total of 283 chronic hepatitis B virus patients（CHB）with low HBV DNA copies（less than or equal to 1 000IU/mL copies）and the data were compared and analyzed.Results HBeAg in patients with low quantitative hepatitis B virus copies showed significant diffenence by chi square test（χ^2=5.310,P〈0.021）.But HBeAb showed no statistical significance by chi square test（χ^2=1.266,P〉0.01）.HBV DNA quantitative results in 20 and 20-10-3 low copy range accounted for 55.56% in 126 cases of small patients without HBeAg（Small Sanyang patients）,and HBV DNA negative results accounted for 21.37% in 117 cases of patients with HBeAg（Big Sanyang patients）.Furthermore,abnormal rates of liver function in AST,ALT and ALP were 15.90%,8.13% and 13.78% respectively.Conclusion Combination of hypersensitive detection of serum HBV DNA copies and quantitative liver function in low-copy patients or patients after antiviral therapy will be of better clinical value,contribute to better understand of viral replication and liver cell injury and provide a reliable basis for treatment.