乙型肝炎不同感染阶段HBV-DNA载量与病程的关系

The quantity of HBV-DNA in hepatitis B patients in different infected stage and their relationships with disease progress

目的 探讨乙型肝炎患者不同感染阶段HBV DNA的载量及与病程的关系。方法 用时间分辨荧光免疫分析系统和适时荧光定量PCR(FQ PCR)方法同时检测 2 99例不同感染阶段的乙型肝炎患者血清中HBeAg及HBV DNA的含量。 结果 不同病程阶段HBV DNA载量和HBeAg的含量是不同的 ,二者呈显著正相关 ,急性乙型肝炎的HBV DNA的载量与慢性乙型肝炎、肝炎肝硬化比较有统计学意义 (P <0 .0 5或P <0 .0 1)。在乙型肝炎血清免疫标志物的不同模式中 ,HBeAg阳性 /ALT异常组中HBV DNA的载量最高 ,HBeAg消失的乙型肝炎患者血清中HBV DNA的载量显著降低 ,但未发现HBeAg消失时HBV DNA载量的阈值 ;HBeAg阳性组、HBeAg阳性 /HBeAb阳性组、HBeAb阳性组的HBV DNA载量均有明显差异 ,且与HBeAg的含量呈显著正相关。结论 HBV DNA的载量和HBeAg的含量不仅是乙型肝炎病毒复制的直观依据 ,也是激发机体免疫反应而引起肝脏损伤的重要原因之一 ,而且对乙型肝炎的早期诊断、传染性的判断及抗病毒治疗方案的制定、药物的筛选及药物的疗效考核等均具有重要的价值。

Objective To study the quantity of HBV DNA in hepatitis B patients in different infected stage and their relationships with disease progress .Methods The quantity of HBV DNA and HBeAg hepatitis B patient of 299 cases in different infected stage were detected by time distinguish fluorescence immunity analysis systematic and fluorescence quantitative PCR (FQ PCR ) at the same time. Results The quantity of HBV DNA and HBeAg in hepatitis B patients was different in different disease progress stage and their relationships were more positive correlated. There were statistic meaning between the quantity that in HBV DNA in acute he patitis B patients and of chronic hepatitis B patients and hepatitis cirrhosis of liver (P<0.05 ,P<0.01).In different pattern of HBV immunology makers, the quantity of HBV DNA in group of positive HBeAg/abnormal ALT was the highest. The quantity of HBV DNA decreased in hepatitis B patients, but threshold value of HBV DNA was not discovered as HBeAg disappearing. The quantity of HBV DNA in HBeAg positive group,HBeAg positive / HBeAb positive group and HBeAb positive group were obvious discrepancy. More positive correlation were observed between the quantity of HBV-DNA and HBeAg.Conclusion The qantity of HBV DNA and HBeAg are not only direct basis of duplicate of hepatitis B virus, but also one of important reason arousing organism immunity reaction leading to liver damage.There are important value for the early diagnosis of hepatitis B,infectious judgement,establishment of virus resistant treatment scheme ,the selection of medicine and check curative effect of medicines ,etc .