HBV DNA检测在血清HBsAg与HBsAb共存模式中的临床价值

目的检测HBsAg与HBsAb共存模式血清中HBV DNA的拷贝数,探讨其在相应患者临床诊疗中的应用价值。方法用ELISA法检测乙肝两对半,统计HBsAg与HbsAb双阳性的血清学模式分布;荧光定量PCR检测HBsAg与HBsAb共存模式标本的HBV DNA病毒载量;在96例共存模式中,按S/CO比值高低将其分为A、B、C、D 4组,计算各组的HBV DNA阳性率。结果在所有HBsAg与HBsAb共存模式中,HBsAg、HBsAb、HBeAg、HBcAb阳性模式比例最高,为53.1%(51/96);HBsAg、HB-sAb、HBeAb、HBcAb阳性模式所占比例为35.4%(34/96)。HBeAg阳性组的HBV DNA阳性率为86%;HBeAg阴性组HBV DNA阳性率为53.1%,两组差异显著(P<0.05)。HBV DNA阳性样本中,HBeAg阳性组的平均病毒载量对数值高于HBeAg阴性组(5.08±1.12/ml vs 4.43±1.15/ml,P<0.05)。在共存模式中,以C组(HBsAg≥2,HBsAb 1.0～1.9)HBV DNA阳性率最高,达61.5%(59/96),显著高于其他各组(P<0.05)。结论对于HBsAg与HBsAb共存模式的血清样品,可用荧光定量PCR技术检测HBV DNA来确定体内病毒是否处于复制状态和载量高低,以提高临床诊断的准确性和改进治疗方法。

Clinical Significance of HBV-DNA Detection for Coexistent Serum Models of HBsAg and HBsAb

Objective HBV DNA copies for coexistent models of HBsAg and HbsAb were detected to discuss the application value for diagnosis and treatment of corresponding cases.Methods HBsAg,HBsAb,HBeAg,HBeAb and HBcAb were detected by ELISA and the statistical distribution of coexistent serum models of HBsAg and HBsAb were obtained.HBV DNA copies were determined for the coexistent serum samples by fluorescence quantitative PCR.Ninety-six cases of coexistent samples were divided into four groups(A,B,C,D) according to the cut off values(CO) of HBsAg and HbsAb.Results Among the coexistent models of HBsAg and HBsAb,the positive model of HBsAg,HBsAb,HBeAg and HBcAb acounted for 53.1%(51/96),and the positive model of HBsAg,HBsAb,HBeAb and HBcAb acounted for 35.4%(34/96).Besides,the positive rate of HBV DNA was 86% in HBeAg positive group and 53.1% in HBeAg negtive group,which showed significant difference(P<0.05).In HBV DNA positve samples,the logarithm value of mean HBV DNA load in HBeAg positive group was significantly higher than that in HBeAg negtive group(5.08±1.12/ml vs 4.43±1.15/ml,P<0.05).The positive rate of HBV DNA in group C was up to 61.5%(59/96),significantly higher than other groups.Conclusion In all coexistent serum models of HBsAg and HBsAb,the HBV DNA are supposed to be determined by fluorescence quantitative PCR to confirm whether HBV replication or not and the level of HBV load,which helps improving the accuracy of clinical diagnosis and therapeutic method.