高灵敏度HBV DNA定量与HBV M的相关性分析

Correlation analysis between high sensitivity HBVDNAquantification and HBV M

目的 探讨高灵敏度的荧光定量PCR检测的乙型肝炎病毒核酸(HBV DNA)与乙肝血清免疫标志物(HBV M之间的相关性及临床意义。方法 选取238例慢乙肝患者标本,同时检测HBV DNA载量和HBV M。根据HBV M模式将结果分为5组,并对HBV DNA载量和HBV M之间的关系进行分析。从中选取174例慢乙肝患者,做肝脏彩超或CT,分析HBV DNA载量水平与肝纤维化发生率之间的关系。结果 Ⅰ组(大三阳组)HBV DNA阳性率为30.8%,Ⅱ组(小三阳组)HBV DNA阳性率为54.4%,两者之间差异有统计学意义(χ^(2)=8.735,P<0.05),不同HBV DNA载量与两对半血清学模式差异亦有统计学意义(χ^(2)=8.798,P<0.01)。不同病毒载量的患者检测到肝纤维化的比例有显著性差异(χ^(2)=26.111,P<0.01)。结论 乙肝小三阳患者HBVDNA处于低载量复制的比率更高,检测到HBV-DNA≥20 IU/mL的病例中乙肝小三阳患者更多,HBV-DNA存在低水平复制的患者肝纤维化发生的比率较高。提高HBV DNA检测的敏感性对决定慢乙肝患者的诊疗方案有重要临床价值。

Objective To investigate the correlation and clinical significance between hepatitis B virus nucleic acid(HBV DNA)and hepatitis B serum immune markers(HBV M)detected by high-sensitivity fluorescence quantitative PCR.Methods 238samples of chronic hepatitis B patients were selected,and HBV DNA load and HBV M were detected at the same time. According to the HBV M mode,the results were divided into five groups,and the relationship between HBV DNA load and HBV M was analyzed.174 patients with chronic hepatitis B were selected for liver color Doppler ultrasound or CT to analyze the relationship between the HBV DNA load level and the incidence of liver fibrosis.Results The positive rate of HBV DNA in group Ⅰ (big three positive group)was 30.8%;the positive rate of HBV DNA in group Ⅱ(small three positive group)was 54.4%,and the difference between the two was statistically significant (χ^(2)=8.735,P<0.05)),the difference between different HBV DNA loads and the two-half serological pattern was also statistically significant (χ^(2)=8.798,P<0.01). There was a significant difference in the proportion of patients with different viral loads that detected liver fibrosis (χ^(2)=26.111,P<0.01).Conclusion The rate of HBVDNA in low-load replication is higher in patients with hepatitis B small three positives. There are more patients with hepatitis B small three positives in cases where HBV-DNA≥20IU/ml is detected. The ratio of the Liver fibrosis occurs in patients with low-level HBV-DNA replication is higher.Improving the sensitivity of HBV DNA detection has important clinical significance for the diagnosis and prognosis evaluation of patients with hepatitis B,especially those with small three positive factors.