实时定量检测乙肝患者HBV DNA及其与抗原抗体模式的关系

Real-time quantitative detection of sera HBV DNA in parients with hepatitis B and its clinical application

目的 探讨乙肝患者血清HBVDNA定量检测的临床意义及与乙肝抗原抗体模式的关系。方法 用Light CyclerTM对 315例乙肝初诊患者进行HBVDNA定量检测 ,同时定量测定乙肝表面抗原、表面抗体 ,e抗原、e抗体和核心抗体等指标 ,观察患者血清中乙肝病毒基因组含量与抗原抗体表型组合的关系。结果 在 16 9例患者血清中检测出HBVDNA ,病毒基因组拷贝值范围为 3 77× 10 2 ～ 3 12× 10 8copies ml,平均拷贝值为 3 6 7× 10 6 copies ml,阳性检出率为 5 3 6 % ;在大多数e抗原阳性的患者血清中均能检测到较高拷贝水平的病毒基因组含量 ;而在e抗原阴性患者中仍有 35 4 %可检测出HBVDNA。结论 LightCyclerTM是测定乙肝病人血清中HBVDNA含量较精确的方法之一 ,能够正确反映乙肝病毒的复制水平和活跃程度 ;乙肝特异性血清学检测结合HBVDNA定量检测分别从蛋白水平和DNA水平反映患者体内病毒的存在状态及机体的反应性 ,对临床诊断、估计病情及用药方案的选择有重要的指导意义。

Objective To study clinical application of Lightcycler real-time quantitative assay in detecting HBV DNA, and investigate the relationship among the marks of hepatitis B virus. Methods Sera from 315 hepatitis B patients were measured by TRFIA for the marks and Lightcycler real-time quantitative PCR assay for DNA. Results 169 sera of HBV DNA were positive with the Lightcycler method which average value was 3.67×106 copies/ml; the positive rate of HBeAg was closely related to the virus loading, which was obviously higher than that of other groups. Conclusion LightCycler TM was one of the most sensitive and reliable assay for detecting HBV DNA, combining the marks of hepatitis B virus will be helpful to give more information about the state of infection and to make treatment program.