慢性乙型肝炎患者HBVDNA含量与T淋巴细胞亚群变化的分析

目的：研究慢性乙型肝炎患者血清HBV DNA含量与外周血T淋巴细胞亚群变化的关系,探讨慢性乙型肝炎患者体内病毒含量与细胞免疫功能的关系。方法采用流式细胞术检测63例慢性乙型肝炎患者和30例体检健康者的外周血T淋巴细胞亚群;应用荧光定量聚合酶链反应检测慢性乙型肝炎患者血清 HBV DNA的含量。结果慢性乙型肝炎患者 HBV DNA阴性组、HBV DNA阳性组与健康对照组比较,CD4＋和CD4＋/CD8＋与健康对照组比较逐渐降低（P＜0．01）。HBV DNA阳性组与 HBV DNA阴性组比较,CD4＋/CD8＋减少（P＜0．05）。HBV DNA低拷贝组、HBV DNA高拷贝组与健康对照组比较,CD4＋和CD4＋/CD8＋明显降低（P＜0．01）。 HBV DNA高拷贝组CD8＋高于健康对照组（P＜0．05）。 HBV DNA高拷贝组的CD4＋低于 HBV DNA低拷贝组（P＜0．05）,CD4＋/CD8＋比值明显降低（P＜0．01）。结论慢性乙型肝炎患者因乙型肝炎病毒感染可导致体内 T 淋巴细胞亚群的改变,HBV DNA高拷贝可加重患者细胞免疫功能的紊乱,使患者的免疫功能持续下降。     

乙型肝炎e抗原阴、阳性慢性乙型肝炎患者细胞免疫状态与乙型肝炎病毒DNA水平相关分析

目的 探讨乙型肝炎e抗原(HBeAg)阴性及HBeAg阳性慢性乙型肝炎患者在细胞免疫状态及乙型肝炎病毒DNA(HBV DNA)水平之间的相关性.方法 分别应用流式细胞仪、荧光定量聚合酶链反应(PCR)方法对HBeAg阴、阳性慢性乙型肝炎患者T淋巴细胞亚群及HBV DNA进行检测.结果 HBeAg阴性慢性乙型肝炎患者的HBV DNA水平与CD8 T淋巴细胞比例之间存在正相关,而与CD4/CD8比值之间存在负相关,γ值分别为0.567,-0.601,均P＜0.01;与总T、CD4 T淋巴细胞比例无相关关系.HBeAg阳性组患者的HBV DNA水平与总T、CD4 T、CD8 T淋巴细胞水平相关关系.结论 HBeAg阴性慢性乙型肝炎患者HBV DNA水平与机体细胞免疫密切相关.     

慢性乙型肝炎患者外周血T淋巴细胞亚群变化与病毒复制的关系

目的探讨慢性乙型肝炎患者外周血T淋巴细胞亚群变化与乙型肝炎病毒（HBV）复制的关系。方法用流式细胞术对81例慢性乙型肝炎患者和30名健康对照者进行外周血T淋巴细胞亚群检测,用荧光定量聚合酶链反应（PCR）测定血清中的HBV DNA含量。结果慢性乙型肝炎患者外周血CD3＋、CD4＋T细胞百分率及CD4＋/CD8＋比值较健康对照者显著降低,而CD8＋T细胞百分率显著升高。与健康对照组相比,HBV DNA阴性患者只有CD4＋/CD8＋比值变化显著;HBV DNA阳性患者CD3＋、CD4＋、CD8＋T细胞百分率及CD4＋/CD8＋比值有显著改变,但高拷贝组和低拷贝组相比,差异无统计学意义。结论慢性乙型肝炎患者感染HBV后免疫功能下降与病毒复制有关,HBV复制可进一步加重免疫功能紊乱。     

乙型肝炎四项指标消长分析及其相互关系研究

目的 探讨HBV DNA与乙型肝炎聚合人血清白蛋白受体（PHSA－Re）、核心抗原（HBcAg）、e抗原（HBeAg）的相互关系。方法 采用荧光定量PCR法检测HBV－DNA，对其中浓度不同阳性102例和阴性36例进一步检测PHSA－Re,HBcAg和HBeAg。结果 102例HBV DNA阳性中PHSA－Re、HBcAg、HBeAg的阳性率分别占86.27%、82.35%、72.55%。36例HBV DNA阴性中PHSA－Re、HBcAg、HBeAg的阳性率分别占38.89%、80.56%、11.11%。PHSA－Re浓度与HBV DNA含量呈正相关递增。结论 HBV DNA阴性患者HBV复制和感染仍有并存，四项指标联合检测更能客观反映HBV复制与感染程度。     

慢性乙型肝炎患者外周血中共价闭合环状DNA的检测

目的 研究慢性乙型肝炎患者外周血中HBVcccDNA的存在状况.方法 采用荧光聚合酶链反应(PCR)法、PCR-微流芯片法对22例慢性乙型肝炎患者外周血血清、白细胞中HBVcccDNA进行平行检测,同时检测其血清HBV DNA含量、HBV M并进行相关性分析,以2例急性戊型肝炎、2例慢性丙型肝炎为对照.结果 22例慢性乙型肝炎患者外周血血清、白细胞中HBVcccDNA分别检出10例和7例,其中2例阳性PCR产物经基因测序得到验证;血清HBV DNA阳性者16例;HBVcccDNA阳性者血清HBV DNA均阳性;对照组上述指标均阴性.结论 慢性乙型肝炎患者外周血血清、白细胞中存在HBVcccDNA;外周血HBVcccDNA与血清HBV DNA存在一定关联.     

HBV前S2抗原、前S2抗体与其病毒标志物的关系

目的：探讨乙型肝炎患者S2抗原,抗体与HBV M,HBV－DNA之间关系。方法：对146例乙型肝炎患者用ELISA法检测前S2抗原,前S2抗体及乙型肝炎病毒标志物（HBV M）;用聚合酶链反应（PCR）法检测乙型肝炎病毒HBV－DNA。结果：急性肝炎,慢性肝炎,肝硬变患者前S2抗原检出率分别为8．33％,77．07％;前S2抗体的检出率分别为75％,9．34％,3．7％,前S2抗原在HBV－DNA,HBeAg阳性病例中检出率明显高于阴性组（P＜0．001）,前S2抗体阳性病例HBV－DNA,HBeAg均为阴性。结论：前S2抗原的检出意味着病毒有复制或有传染性,前S2抗体的出现标志着病毒被清除,在慢性肝病中检出并不意味病情稳定,同时发现该抗体可以在急性乙型肝炎急性期及血清HBV M全部阴性的患者中检出。     

乙型肝炎患者血清HBV cccDNA检测的临床意义

目的观察乙型肝炎患者乙型肝炎病毒（HBV）共价闭合环状DNA（covalently closed circular DNA,cccD-NA）在血清中的分布特点及与HBV感染状态的联系,探讨HBV cccDNA与患者病情的轻重、HBV的复制指标（HBeAg、HBV DNA）的关系。方法分别采用PCR荧光分子信标、荧光定量PCR、酶联免疫吸附分析法（ELISA）检测162例乙型肝炎患者外周血清中HBV cccDNA定量、HBV DNA定量和乙型肝炎病毒标志物。结果162例乙型肝炎患者,血清HBV cccDNA阳性率为48.15%（78/62）。HBV cccDNA阳性率在HBV DNA阳性患者中为60.94%（78/128）,显著高于HBV DNA阴性者[0（0/34）]（P〈0.01）;HBeAg阳性患者HBV cccDNA检出率为61.70%（58/94）,显著高于HBeAg阴性者29.04%（20/68）（P〈0.01）;中、重度慢性乙肝患者HBV cccDNA检出率为58.97%,高于轻度慢性乙型肝炎患者（45.45%）（P〈0.05）。重型肝炎患者HBV cccDNA阳性者存活率（37.5%）明显低于HBV cccDNA阴性者（78.26%）（P〈0.05）。结论HBV cccDNA仅存在于血清HBV DNA阳性乙型肝炎患者外周血清中;HBV cccDNA检出率与外周血HBV复制指标（HBeAg、HBV DNA）有显著的相关性,并与肝细胞炎症相关,是乙型肝炎病毒在患者体内大量复制及肝细胞损伤的血清标志。     

HBV外膜大蛋白在判断HBV复制中的价值

目的通过检测慢性乙型肝炎患者血清乙型肝炎病毒（HBV）外膜大蛋白（LP）、DNA、前S1抗原（PreS1）并进行比较分析,探讨血清HBV-LP检测在慢性乙型肝炎中的诊断价值。方法采用酶联免疫吸附试验（ELISA）检测416例慢性乙型肝炎患者乙型肝炎e抗原（HBeAg）、HBV-LP和HBV-PreS1,并应用实时荧光定量聚合酶链反应（PCR）平行检测HBV DNA。按HBeAg阴阳性不同分组,比较HBV-LP、HBV-PreS1及HBV DNA阳性率的差异。结果 416例慢性乙型肝炎患者血清HBV-LP有较高的阳性检出率（76.68%）,与HBV DNA的阳性率（72.60%）差异无统计学意义（P〉0.05）,两者阳性率均高于HBV-PreS1阳性率（36.06%,P〈0.01）;在HBeAg阴、阳性患者中,HBV-LP与HBV DNA的阳性率差异均无统计学意义（P均〉0.05）,均显著高于HBV-PreS1阳性率（P〈0.01）。结论血清HBV-LP水平能反映慢性乙型肝炎患者体内HBV复制程度,其敏感性高于HBV-PreS1,可作为判断HBV复制新的血清学指标。     

乙型肝炎患者外周血B淋巴细胞CD5 mRNA表达水平的研究

目的 建立CD5 mRNA的逆转录聚合酶链反应（RTP－PCR)测定法，探讨外周血B淋巴细胞CD5 mRNA水平与乙型肝炎慢性化和严重化的关系。方法 运用RT－PCR技术，建立了B淋巴细胞中CD5基因mRNA表达水平的半定量测定方法，对急、慢性乙型肝炎和肝炎后肝硬化患者进行了研究。结果 急性乙型肝炎患者组外周血B淋巴细胞中CD5 mRNA的水平与正常对照组无显著性差别，其余各乙型肝炎患者组均显著高于对照组。且肝炎后肝硬化组＞慢性乙型肝炎组＞急性肝炎组（P＜0．01）。结论 外周血B淋巴细胞CD5 mRNA水平与乙型肝炎的发病和慢性化发展密切相关。     

乙型肝炎病毒几种标志物相关性分析

目的探讨慢性乙型肝炎患者几种标志物即乙型肝炎病毒（HBV）两对半（HBV-M）、前S1抗原（PreS1）及HBV DNA检测的相关性。方法HBV-M和PreS1采用酶联免疫吸附试验法检测，HBVDNA采用实时聚合酶链反应法检测。结果131例慢性乙型肝炎患者的HBV—M检测中，“大三阳”，“小三阳”，乙型肝炎病毒表面抗原（HBsAg）阳性、乙型肝炎病毒核心抗体（抗-HBc）阳性三种典型感染模式为126例，占96．2％；其中72例大三阳阳性病例中PreS1和HBV DNA阳性分别为60例和72例，阳性率分别为83．3％和86．1％，而42例小三阳阳性病例中PreS1和HBV DNA阳性分别为12例和28例，阳性率为28．6％和66．7％；在78例PreS1阳性患者中HBV DNA阳性占68例，其阳性率为87．2％，48例PreS1抗原阴性的患者中HBV DNA阳性为32例，其阳性率为66．7％。结论在慢性乙型肝炎患者HBV-M检测“大三阳”模式中PreS1与HBV DNA均表现高阳性率，二者具有良好的相关性（P〈0．01）；而“小三阳”模式中PreS1阳性率较低，但HBV DNA仍有较高的阳性率，表明在慢性乙型肝炎患者“小三阳”模式中HBV DNA检测比PieS1检测更有价值（P〈0．01）。值得注意的是研究中PreS1阳性和阴性患者均有较高的HBV DNA阳性率，二者没有明显差异（P〉0．05）。因而，在临床诊断、治疗和疗效观察中HBV DNA可作为检测金标准，而PreS1阴性的患者也不应忽视。     

Hepatitis B virus DNA and hepatitis B surface antigen levels in chronic hepatitis B

Despite universal vaccination, chronic hepatitis B (CHB) continues to be a major health burden worldwide, with an estimated 350–400 million people infected with the virus. Over the past decade, rapid progress has been made with regards to antiviral therapy for CHB, from conventional interferon to pegylated interferon, and with the earliest oral agent lamivudine to the current, more potent drugs such as entecavir and tenofovir. There have also been new developments in the diagnostic and monitoring tools for CHB. Qualitative hepatitis B surface antigen (HBsAg) testing has been used to diagnose patients infected with CHB. More recently, quantitative HBsAg titers have been used to predict treatment outcome when measured at baseline or early into treatment. The progress on the use of hepatitis B virus (HBV) DNA levels has been more rapid. Serum HBV DNA levels have been shown to be important in the natural history of CHB infection, with higher levels being significantly associated with the development of cirrhosis and hepatocellular carcinoma. For patients receiving antiviral therapy, the baseline and early on-treatment HBV DNA levels are important in determining treatment outcomes. Monitoring of HBV DNA levels during therapy will allow for early detection of drug resistance. The end-of-treatment and post-treatment HBV DNA levels have been demonstrated to be important indicators of treatment success and relapse, respectively. With newer and more powerful antiviral agents, and with the development of quantitative assays that are highly sensitive, further studies are needed to optimize the use of these tools and agents in the modern management of CHB.     

HBV-LP检测在慢性乙型肝炎患者抗病毒治疗中的应用

目的 探讨乙型肝炎病毒外膜大蛋白(HBV-LP)检测在慢性乙型肝炎患者抗病毒治疗中的应用价值.方法 对抗病毒治疗有效并-70 ℃冻存的56例慢性乙型肝炎患者系列血清做HBV-LP、雅培(ABBOTT)乙型肝炎两对半和HBV DNA定量检测.结果 在56例抗病毒治疗有效病例中,HBeAg阳性组的HBV-LP的A值为1.11±0.40,阴性组的A值0.561 6±0.21,差异有统计学意义.56例干扰素治疗有效病例的HBV-LP和HBV DNA随用药时间的同时下降,两者有很好的相关性,P=0.023 2,r2=0.860 3.结论 HBV-LP可作为判断慢性乙型肝炎抗病毒较为可靠的指标,尤其在HBeAg阴性的乙型肝炎患者进行抗病毒治疗时更具有重大意义.     

The role of beta2 microglobulin levels in monitoring chronic hepatitis B

Beta2 microglobulin is one of the domains of the histocompatibility class I human leukocyte antigen (HLA) antigen. In hepatitis infection the presentation of the viral antigen on the hepatocyte in the presence of class I HLA antigens plays a significant role in the elimination of the virus. The aim of the study was to estimate the serum beta2 microglobulin levels in cases of chronic hepatitis B infection. Serum beta2 microglobulin levels were assessed in 65 cases with chronic hepatitis B infection including 29 pediatric and 36 adult patients as the study group and in 30 cases as seronegative control group. Beta2 microglobulin level was found significantly higher in chronic active Hepatitis B virus (HBV) patients compared to the asymptomatic HBV carriers and also in the chronic active HBV patients compared to control group. We are of the opinion that beta2 microglobulin concentration is an indicator for monitoring chronic active HBV infections at the asymptomatic hepatitis B virus carrier patients, thus would lead to early initiation of Interferon (IFN) treatment and to monitor the effectiveness of the therapy.     

趋化因子CCL20在慢性乙型肝炎活检组织中的表达及意义

目的 研究慢性乙型肝炎(CHB)肝活检组织CCL20的表达与病理分级分期的关系,探讨CCL20在慢性HBV感染中的作用及意义.方法 通过内参照竞争逆转录聚合酶链反应(RT-PCR)对处于正常状态和慢性感染状态的肝细胞系的CC120 mRNA进行定量检测,观察CCL20的表达差异.定量检测正常肝脏和CHB活检组织的CC120水平,结合肝脏组织学积分研究其相关性.结果 在体外细胞系水平上,HBV未感染肝细胞HepG2的CCL20表达量为(2.65±0.02)pg/106细胞,而HBV持续感染肝细胞HepG2.2.15的CC120表达量为(1.22±0.04)pg/106细胞(t=39.66,P<0.01);PMA刺激CCL20表达的增加但不改变CCL20在二类细胞之间的表达格局.在HBV慢性感染状态下肝活检组织的CCL20的表达(3.54±0.65)pg/20 mg显著低于其在正常肝组织中的平均表达量(8.74±0.56)pg/20 mg(t=30.09,P<0.01),且与肝脏的组织学积分相关(r=0.675,P=0.023).结论 HBV慢性感染状态下CCL20的表达下调,CCL20的表达与CHB患者肝脏组织学积分相关.     

Immunological and Antiviral Responses After Therapeutic DNA Immunization in Chronic Hepatitis B Patients Efficiently Treated by Analogues

A substudy of a phase I/II, prospective, multicenter clinical trial was carried out to investigate the potential benefit of therapeutic vaccination on hepatitis B e antigen-negative patients with chronic hepatitis B (CHB), treated efficiently with analogues. Patients were randomized in 2 arms, one receiving a hepatitis B virus (HBV) envelope DNA vaccine, and one without vaccination. At baseline, HBV-specific interferon (IFN)-γ–producing T cells were detected in both groups after in vitro expansion of peripheral blood mononuclear cells. Vaccine-specific responses remained stable in the vaccine group, whereas in the control group the percentage of patients with HBV-specific IFN-γ–producing T cells decreased over time. The vaccine-specific cytokine-producing T cells were mostly polyfunctional CD4⁺ T cells, and the proportion of triple cytokine-producer T cells was boosted after DNA injections. However, these T-cell responses did not impact on HBV reactivation after stopping analogue treatment. Importantly, before cessation of treatment serum hepatitis B surface antigen (HBsAg) titers were significantly associated with DNA or HBsAg clearance. Therapeutic vaccination in CHB patients with persistent suppression of HBV replication led to the persistence of T-cell responses, but further improvements should be searched for to control infection after treatment discontinuation.     

Purification and characterization of a naturally processed hepatitis B virus peptide recognized by CD8+ cytotoxic T lymphocytes.

In vitro studies in patients with hepatitis B virus (HBV) infection have suggested that hepatocytolysis induced by CD8+ cytotoxic T lymphocytes (CTLs) is the most important effector pathway in eliminating infected cells. The recognition is implicated in the endogenously processed HBV antigens in the context of HLA class I molecules presented on the liver cell membrane. However, the naturally occurring HBV peptide antigens have not yet been demonstrated. We report here that a naturally processed peptide antigen P2 was isolated from HLA class I molecules of HBV-infected liver cell membrane. The P2 peptide exhibited the activity of sensitizing target cells for lysis by CD8+ CTLs. The P2 sequence (YVNVNMGLK) purified from liver tissue was in concordance with that encoded by the viral genome for the HBV nucleocapsid antigen or HBcAg 88-96. P2 peptide could also be isolated from the EBV-transformed B cells that were transfected by HBcAg-expressing vector. The P2 epitope, sharing the HLA-A11 binding motifs, was recognized by HLA-A11-restricted CD8+ CTLs. The data provided direct evidence that, in hepatitis B patients, antigenic peptides of HBV were processed by hepatocytes, presented with the class I MHC molecules, and recognized by CD8+ CTLs.     

Synergistic effect of 5-azacytidine and gamma-interferon or dimethyl sulfoxide on expression of HLA class I antigens by PLC-PRF-5 cells

In order to elucidate the mechanism by which HLA antigens expression is induced or enhanced on the injured or transformed hepatocytes, we have made in vitro studies using human hepatic tumor-derived cell lines as a model system. In the present study, PLC-PRF-5 cells that have the integrated form of hepatitis B virus genome in DNA were treated with 5-azacytidine (5-azaC) in combination with gamma-interferon (IFN-gamma) or dimethyl sulfoxide (DMSO). HLA antigens on the cell surface were quantitated by using a modified cell-ELISA method. As a result, it was demonstrated that DMSO- or IFN-gamma-treatment enhanced expression of HLA class I antigens on the cell surface. In addition, enhanced expression of the antigens on PLC-PRF-5 cells treated with 5-azaC in combination with IFN-gamma or DMSO represented a synergistic effect of these inducers on HLA class I antigens expression although no changes in HLA antigens expression were induced after 5-azaC-treatment alone in short-term experiments. Furthermore, an indirect immunofluorescent analysis of hepatitis B surface antigen on the cells demonstrated increased expression of the antigen after 5-azaC-treatment alone. HLA class II antigens and hepatitis B core antigen were not induced even after those treatments and also not after a long-term experiment. These results might indicate possible modulation of HLA class I and hepatitis B virus antigens expression on the cultured cells by a DNA hypomethylating agent, 5-azaC.     

慢性乙型肝炎患者的乙型肝炎病毒基因型与细胞免疫功能的关系

目的探讨慢性乙型肝炎（cHB）患者的乙型肝炎病毒（HBV）基因型与细胞免疫功能的关系及其临床意义。方法对108例CHB患者用聚合酶链反应（PCR）微板核酸杂交-酶联免疫吸附测定（ELISA）技术进行HBV基因分型,用流式细胞仪检测T细胞亚群、非特异性细胞毒性T淋巴细胞（CTL）、辅助性T细胞（Th）1、Th2、自然杀伤（NK）细胞,对其中55例人白细胞抗原（HLA）-A2阳性CHB患者检测HBV特异性CTL。结果108例CHB患者中,B基因型59例（54．6％）,C基因型48例（44．4％）,B、C混合型1例（0．9％）,HLA—A2阳性55例（51．4％）中,C基因型感染者27例,B基因型感染者28例;乙型肝炎病毒e抗原（HBeAg）阳性率高于B基因型感染者（75．0％VS49．2％）（P〈0．01）,C基因型的HBVDNA水平高于B基因型感染者（6．12±0．81）log10copies／mlvs（5．02±0．61）log10 copies／ml（P〈0．01）,HBV特异性CTL低于B基因型感染者（0．21±0．06）％vs（0．39士o．12）％（P〈0．01）。非特异性CTL高于B基因型感染者（19．84±6．17）％vs（16．81±3．56）％（P〈0．01）,丙氨酸转氨酶（ATL）高于B基因型感染者（505．12±312．91）U／Lvs（222．11±205．16）U／L（P〈0．01）,血清总胆红素（TBIL）高于B基因型感染者（45．71±41．12）μmol／Lvs（28．18±15．12）μmol／L（P〈0．05）。结论与CHBB基因型感染者相比,C基因型感染者的HBV特异性CTL较低,导致HBVDNA水平高于B基因型感染者,HBeAg阳性率也高于B基因型感染者,因此C基因型感染者的肝功能损害比B基因型感染者重,C基因型感染者的肝功能损害比B基因型感染者重,可能也与C基因型感染者的非特异性CTL比B基因型感染者高有关。     

乙型肝炎病毒基因型与耐药病毒株的相关性研究

目的研究乙型肝炎病毒(HBV)基因型与耐药病毒株产生的相关性。方法征集340例接受拉米夫定治疗1年以上的慢性乙型肝炎(CHB)患者为研究对象。采集血样经离心分离血浆,进行HBV DNA定量检测,再进行基因测序和基因分型。结果基因测序和基因型分析结果为:A型16例(4.7%),B型112例(32.9%),C型148例(43.5%),D型44例(12.9%),B/C混合型20例(5.9%)。其中发生YMDD耐药突变的基因型分别是:A型4例(25.0%),B型20例(18.5%),C型64例(42.1%),D型8例(18.2%),B/C混合型4例(20.0%)。结论 HBV基因型C发生YMDD耐药突变的频率较高,HBV基因型与YMDD突变可能存在相关性。     

乙肝肝硬化患者血清HBsAg与HBVDNA比值在不同病程差异及疗效价值研究

目的 研究分析乙型肝炎表面抗原(HbsAg)与乙型肝炎病毒(HBV)DNA比值在不同严重程度慢性乙型肝炎(CHB)病毒感染患者中差异及其对疗效的预测价值。方法 选取该院33例轻中度CHB者为A组、41例重度CHB者为B组和38例乙型肝炎肝硬化者为C组。对各组患者总胆红素(TBIL)和谷氨酸氨基转移酶(ALT)等指标的水平进行检测,并对其HBsAg,HBV DNA进行检测。结果 ①C组HBsAg,HBV DNA较A,B组均显著降低(P<0.05),而三组间HBsAg与HBV DNA比值的比较,差异无统计学意义(P>0.05); ②A组与B组HBsAg,HBV DNA,HBsAg与HBV DNA比值的比较,差异均无统计学意义(P>0.05)。③完全应答组治疗后3个月HBsAg,HBV DNA较治疗前均显著降低,差异有统计学意义(P<0.05),HBsAg与HBV DNA比值较治疗前显著升高(P<0.05)。④部分应答组、无应答组治疗后3个月HBsAg与治疗前比较,均无统计学意义(P>0.05),而HBV DNA较治疗前均显著降低(P<0.05)。⑤HBsAg与HBV DNA比值较治疗前均显著升高(P<0.05)。⑥相比HBsAg(0.54),HBV DNA(0.42),HBsAg与HBV DNA比值预测临床疗效的ROC曲线下面积(0.67)显著升高。结论 乙型肝炎肝硬化患者HBsAg与HBV DNA比值明显高于CHB患者,并且该比值对疗效的预测价值明显高于HBsAg,HBV DNA。