抗HBs对HBsAg和抗HBs共存慢性HBV感染者的临床价值

The Clinical Value of Anti-HBs for Chronic Hepatitis B Infected Patients with HBsAg and anti-HBs Co-existence

目的研究抗HBs对HBsAg/抗HBs共存慢性HBV感染者的临床价值。方法对76例样本用化学发光法定量检测HBsAg、抗HBs、HBeAg,用RTPCR法检测HBVDNA,按HBsAg和抗HBs水平分组,分析其分布特征;采用X^2检验比较抗HBs不同水平组HBeAg阳性率和HBVDNA阳性率的差异。结果 76例HBsAg/抗HBs共存慢性HBV感染者中,抗HBs低水平者(<100mIU/mL)7.9%,中等水平者(100～1000mIU/mL)21.1%,高水平(>1000mIU/mL)者未见;抗HBs中等水平组的HBeAg阳性率(93.8%)明显高于抗HBs低水平组HBeAg阳性率(58.3%),抗HBs中等水平组的HBVDNA阳性率(100%)明显高于抗HBs低水平组HBVDNA阳性率(67.9%)。结论在HBsAg/抗HBs共存的慢性HBV感染者中,抗HBs具有重要的辅助诊断价值,表现为:大多数呈低水平且不可能出现高水平抗HBs;抗HBs水平与HBeAg和HBVDNA所反映的HBV复制水平有关。

Objective To study the clinical value of anti-HBs for the chronic hepatitis B infected patients with HBsAg and anti- FIBs coexistence. Methods Serum from 76 patient samples were tested for HBsAg, anti- HBs, HBeAg by CMIA and for HBVDNA by RTPCR, then the distribution features of HBsAg and antiHBs were analyzed; the positive rates of HBeAg and HBVDNA were compared between middle anti-HBs group and low anti-HBs group. Results Among the 76 samples, the proportions of samples with low, middle and high anti-HBs were 78.95% ,20.05% and zero, respectively. The positive rates of HBeAg and HBVDNA were both higher in the middle anti-HBs group than that in the low anti-HBs group. Conclusion Anti-HBs can facilitate the diagnosis of the chronic hepatitis B infected patients with HBsAg and anti-HBs coexistence, including ：（1） most of them has low level anti-HBs and high-level anti-HBs could hardly be found,（2） levels of anti-HBs is correlated with HBV replication status（ HBeAg and HBVDNA）.