初诊慢肝患者血清中乙肝病毒DNA载量与血清标志物的关系

目的探讨初诊慢性乙型肝炎血清标志物与HBV DNA的关系。对象与方法采用酶联免疫方法和荧光定量聚合酶链反应分别对512例不同乙肝病人及202例HBeAg阴性、257例HBeAg阳性慢肝病人进行血清标志物、HBV DNA定量检测并分析结果。结果慢肝组有315例(68.9%)病毒颗粒浓度高于107,肝硬化组7例(13.2%)病毒颗粒浓度高于107;HBeAg阳性慢肝组245例(95.3%)患者病毒颗粒含量高浓度,HBeAg阴性慢肝组68例(33.7%)患者病毒颗粒含量在105-7copy/mL区段。结果慢肝组与肝硬化组相比,高浓度病毒以慢肝组中最明显,病情发展至肝硬化期病毒含量多数不高;慢肝病人中不同乙肝血清标志物模式其病毒含量分布特点不同,与HBeAg阳性慢肝组相比HBeAg阴性组体内病毒复制水平低(p<0.01),传染性较前者弱。最常见前C区突变,导致HBeAg阴性CHB病情加重和病毒复制增加。

Analysis of relationship between hepatitis B virus markers and HBV DNA levels in patients with chronic hepatitis B

Objective To determine the relationship between hepatitis B virus serum markers and HBV DNA levels in patients with chronic hepatitis B.Methods Serum markers and HBV DNA were assayed by ELISA and PCR.Results In 202 patients with HBeAg-negative and 257 patients with HBeAg-positive chronic hepatitis B.In 95.3% HBeAg-positive samples PCR average was 10~610~8 copies/ml.In 33.7% HBeAg-negative samples the average was 10~5-10~7.[WTHZ]Conclusions Serum HBV DNA level is the indicator in the patients with HBeAg-negative chronic hepatitis B,That Serum HBeAg-negative but HBV DNA duplicate actively may indicate that there is C-zone mutation in patients with HBeAg-negative chronic hepatitis B.PCR can be used to monitor the true state of HBV infection and amplification.