HBV DNA定量与乙型肝炎临床及病理关系的探讨

Study on Clinical and Pathological Relationship between the Quantity of HBV DNA and Hepatitis B

目的 探讨HBVDNA定量与各型乙型肝炎临床及病理的关系。方法 采用美国PE公司生产的 5 70 0型荧光定量PCR仪 ,对 83 8例乙型肝炎病毒单纯感染的各型肝炎患者行HBVDNA定量检测 ,并同时检测其它乙型肝炎病原学标志物 ,对部分患者行肝穿刺病理检查。结果 慢性乙型肝炎、肝硬变、慢性重型肝炎中 ,HBVDNA定量检测与乙型肝炎血清学标志有明显的一致性。HBsAg、HBeAg、HBcAb阳性模式、HBsAg、HBcAb阳性模式和HBsAg、HBeAb、HBcAb阳性模式与HBVDNA阳性的符合率分别为 94.3 8%、3 8.5 6%、2 7.3 0 %。各型肝炎的HBVDNA定量比较无显著差异 (P >0 .0 5 ) ,但慢性乙型肝炎HBVDNA阳性率明显高于肝硬变及慢性重型肝炎组 (P <0 .0 0 1)。 15例患者的HBVDNA定量与肝脏病理学分析 ,HBVDNA定量与肝组织炎症及纤维化无明显相关。结论 HBVDNA定量检测特异性强 ,灵敏度高 ,与HBeAg阳性呈正相关 ,是乙型肝炎诊断和观察抗病毒治疗的一项可靠的判断指标。但与肝组织炎症及纤维化无明显相关。

Objective To study the clinical and pathological relationship between the quantitative analysis of HBV DNA and all kinds of hepatitis B.Method HBV DNA in 838 patients who simply suffered from HBV was detected quantiticationally by fluorescence quantificational PCR instrument,meanwhile other HBV pathogenic markers were detected.Liver puncture pathological detemination was carried out in partial patients.Results There was a remarkable consistency between HBV DNA quantity and the serum markers of hepatitis B in chronic hepatitis ,hepatocirrhosis and chronic severe hepatits.The consistency rates of HBsAg,HBeAg and HBcAb positive mode,HBsAg,HBcAb positive mode and the HBsAg,HBeAb,HBcAb positive mode to HBV DNA positivity were 94.38%,38.56% and 27.30% respectively.There were no statistical significant difference in the HBV DNA quantity among all kinds of hepatitis( P >0.05),except the positive rate of HBV DNA in chronic hepatitis B was significantly higher than that in hepatocirrhosis and chronic severe hepatitis group( P< 0.001).Comparing 15 cases of HBV DNA quantity and pathological analysis,there were no significant correlations between HBV DNA quantity and organic inflammation and fibrosis.Conclusions HBV DNA quantity detection is a method with high specificity and high sensitivity,which has a positive correlation with HBeAg positivity.It is a reliable judgement index for diagnosis of HBV and anti virus therapy observation,but it has no obvious correlation with the liver inflammation and fibrosis.