慢乙肝患者血清HBV DNA与肝细胞内HBsAg和HBcAg表达的相关性研究

目的　探讨慢乙肝患者血清HBVDNA的表达与肝细胞内HBsAg和HBcAg表达的相关性。方法　应用定量PCR技术检测 170例乙肝患者的血清HBVDNA ,同时应用免疫组化技术测定其肝细胞内HBsAg及HBcAg含量。结果　⑴慢乙肝患者不论血清HBVDNA是否阳性 ,肝细胞内均可检出HBsAg ;但HBVDNA载量低者 ,肝细胞内HBsAg含量较低 (P <0 0 5 )。血清HBVDNA阴性者 ,HBcAg无一例检出。⑵血清HBVDNA载量越高 ,患者肝细胞内HBcAg的阳性率明显升高 (P <0 0 5 )。⑶肝组织炎症G2期以上的慢乙肝患者血清HBVDNA阳性较阴性的多 (P <0 0 5 ) ,但并不与HBVDNA载量高低相伴随 (P >0 0 5 )。而G2期以上的慢乙肝患者肝细胞内HBcAg的阳性率明显升高 (P <0 0 5 )。结论　慢乙肝患者血清HBVDNA的表达与肝细胞内HBsAg和HBcAg表达密切相关。肝细胞内HBsAg的表达是筛查HBV感染的敏感指标 ,HBcAg是评价HBVDNA复制程度的较可靠指标。

A Study on Relationship between Serum HBV DNA and HBsAg , HBcAg Expression in the Hepatocytes in Chronic Hepatitis B Patients

Objectives To study the relationship between serum HBV DNA and HBsAg, HBcAg expression in the hepatocytes in chronic hepatitis B(CHB) patients. Methods Quantitative polymerase chain reaction was used to assay the content of serum HBV DNA in 170 CHB patients. The expression of HBsAg and HBcAg in hepatocyctes was detected by immunohistochemical staining using liver biopsy. Results Although serum HBV DNA was negative, the expression of HBsAg in hepatocyctes was still observed in the CHB patients. In the CHB patients with lower level of serum HBV DNA, the positive rate of HBsAg expression in hepatocyctes was also lower (P<0.05). In the patients with negative serum HBV DNA, the expression of HBcAg in hepatocyctes was not observed. The expression level of HBcAg in hepatocyctes was positively correlated with the content of serum HBV DNA. Over G2 stage inflammation of liver tissue was more in the patients with positive HBV DNA than in the patients with negative HBV DNA, while was not correlated with the content of serum HBV DNA. Conclusion The content of serum HBV DNA was closely correlated with the expression of HBsAg and HBcAg in the hepatocytes in chronic hepatitis B patients. HBsAg might be a sensitive index to screen HBV infection. HBcAg might be a reliable index to evaluate the replication of HBV.