乙肝系列血清学标志和HBV DNA定量分析

Quantitative analysis of HBV DNA and serological markers of hepatitis B

目的 :探讨乙型肝炎病毒血清学指标的表现模式与HBVDNA之间的内在联系。方法 :949例在本院就诊有诊断不同的病人血清标本 ,用ELISA法检测 949例病人血清标本的各血清免疫学标志 ,用荧光定量PCR法实时定量检测HBVDNA。结果 :HBeAg阳性的标本HBVDNA全部呈阳性 ,阳性率达 1 0 0 % ,并且HBVDNA载量平均值大于 1 0 7拷贝 /ml。HBsAg、抗 HBe、抗 HBc阳性的模式中HBVDNA阳性率高达 84.1 % ,平均拷贝数在 1 0 6 ～ 1 0 7/ml之间。有 61例检测不到e系统 ,但有 59例HBVDNA呈阳性 ,平均拷贝数也较高。HB sAg阴性而其他抗体阳性的HBVDNA阳性率达 9.7% ,平均拷贝数较低 ,在 1 0 4 /ml左右。ELISA法全阴的HBVDNA阳性率为 4 .2 % ,平均拷贝数为 1 0 4 /ml。抗 HBc IgM阳性者 ,HBVDNA阳性率为 98.7%。前S1 蛋白阳性者 ,HBVDNA阳性率为 93 .8%。结论 :尽管HBeAg、抗 HBc IgM、前S1 蛋白 (PreS1 )等血清学标志是乙肝病毒复制的良好指标 ,但不能代替HBVDNA的定量测定 ,只有HBVDNA才是乙型病毒性肝炎复制和传染性的直接病原学依据。这种实时定量检测的荧光定量PCR技术可以检测HBV的真实感染和复制情况 ,它和ELISA法检测的血清学指标相结合 。

Objective: To state the internal relations between expressional patterns of serological mar kers of HBV and HBV DNA.Methods: Immunological markers and HBV DNA concentrations of 949 serum were detected by t he ELISA and FQ-PCR. Results: The HBV DNA with positive HBeAg are all positive(100%). The average concentrati ons of HBV DNA were above 10 7 copies/ml. The positive rate of HBV DNA in HBsAg +,Anti-HBe+,Anti-HBc+ was as high as 84.1%,and the average concentrations of HBV DNA were between 10 6 and 10 7 copies/ml. HBV DNA in 59 HBeAg(-) samples we re positive. Its average number of copies was also rather high. The rate of posi tive HBV DNA with nigative HBsAg and other positive antibodies is 9.7%,and the a verage number of copies is rather low,about 10 4 copies/ml. The rate of positiv e HBV DNA with all negative antibodies is 4.2%,and its average is 10 4 copies/ml. When Anti-HBc-IgM is positive,the rate of positive HBV DNA is 98.7%;when PreS 1-Albumen is positive,the rate is 93.8%. Conclusion: Although such serum indications as HBeAg,Anti-HBc-IgM,PreS 1 are good indexes of the copy of HBV,they certainly cannot take the place of HBV DNA's quantitat ive test. Only HBV DNA is the foundation of the copy of HBV and the infectious d irect actiology. This kind of PCR could detect HBV's real infection and its co ncentrations. When it's combined with the markers of serum by the ELISA method, its clinical value is extremely great.