慢性乙型肝炎患者血清HBV DNA水平与肝组织病理及免疫组化水平的关系

目的探讨慢性乙型肝炎患者血清HBV DNA水平与肝组织病理及免疫组化水平的关系。方法检测76例慢性乙型肝患者血清及肝组织外周血HBsAg，如BeAg和HBV DNA水平，常规病理和肝组织内的HBsAg，HBcAg。结果外周血中HBeAg阳性的患者中有91．49％HBV DNA阳性，而在如BeAg阴性的患者中，有58．62％的患者HBV DNA阳性，只有慢性乙型肝炎轻度患者的血清HBV DNA水平与其他各组差异有显著性（P〈0．05），而其余各组之间HBV DNA的复制水平均无明显差异，中度以上的血清HBV DNA多呈高水平分布。所有样本肝组织的HBsAg均为阳性，从肝组织不同HBsAg表达强度下，HBcAg表达的趋势来看，HBcAg有随着HBV DNA量的增加而表达增强的趋势。结论患者血清HBV DNA水平的变化可以反映HBV的复制水平而不能反应肝脏损伤程度。同时肝组织内的HBsAg检测更适合于低水平HBV感染的患者。

Relationship between serum HBV DNA level and hepatic pathological and immunohistochemical changes in chronic hepatitis B

Objective To study the relationships between serum HBV DNA level and hepatic pathological and immunohistochemical changes in chronic hepatitis B. Methods 76 patients were tested for serum HBV DNA level, HBsAg and HBeAg. Histology of the liver was examind. The HBsAg and HBcAg expression in the liver was detected by immunohistochemistry. Results HBsAg expression in liver tissues were all positive. The HBV DNA level of CHB with low level was different with other levels(P<0.05). The HBV DNA level in serum was not correlated with pathological changes in the liver. The HBcAg expression in the liver showed increasing trend with serum HBV DNA level. Conclusion Serum HBV DNA level can reflect the infectivity of serum. The test of HBsAg expression in the liver tissues is more valuable for the CHB patients with lower HBV DNA level.