乙型肝炎病毒血清学标志物与HBV-DNA含量的相关性分析

目的分析乙型肝炎病毒载量（HBV-DNA）与乙肝病毒血清标志物（HBVM）之间的关系。方法运用酶联免疫吸附测定法（ELISA法）、荧光定量聚合酶链反应（FQ-PCR）技术对200例乙型肝炎患者分别检测血清标志物及HBV-DNA含量。结果当HBV-DNA含量在107-108U/ml时,HBeAg阳性的大三阳模式组即HBsAg＋HBeAg＋HBcAb＋的血清学检测率（45.3%）明显高于其他模式组,HBV-DNA含量在不同模式组有显著性差异（P〈0.01）;当HBV-DNA含量在103-104U/ml时,小三阳模式组即HBsAg＋HBeAb＋HBcAb＋的血清学检测率（61.3%）明显高于其他模式组,HBV-DNA含量在不同模式组有显著性差异（P〈0.01）;而在4例HBV血清标志物全阴性的标本中仍检出HBV-DNA;1例HBsAb＋患者也检出了HBV-DNA.结论在各种HBV模式中,以HBeAg阳性者病毒复制水平最高,而血清中未检出标志物者并不能排除HBV感染,HBsAb＋的病人也可能有传染性。两种方法联合检测对临床有不同的指导意义。

Correlation Analysis of Hepatitis B Virus Serological Markers and HBV-DNA

Objective To analyze the relationship between hepatitis b virus titer（HBV-DNA）and its serum markers（HBVM）.Methods HBVM and HBV-DNA in 200 hepatitis b patients were determined using enzyme-linked immunosorbent assay（ELISA）and fluorescence quantitative polymerase chain reaction（FQ-PCR）.Results when HBV-DNA was 107~108U/ml,the serological detection rate（45.3%）in HBeAg positive group（HBsAg＋ HBeAg＋ HBcAb＋）was much higher than that in the other groups.HBV-DNA levels were significantly different in various groups（P0.01）.When HBV-DNA was 103-104U/ml,the serological detection rate（61.3%）in HBsAg＋ HBeAb＋ HBcAb＋ group was higher than that in the other groups.HBV-DNA levels were significantly different in various groups（P0.01）.HBV-DNA was detected in four patients with negative serum markers and one patient with positive HBsAb.Conclusion In various HBV patients,the highest viral replication level（107~108U/ml）is seen in HBeAg positive patients.HBV infection can not be ruled out even if the serum markers was not detected.HBsAb＋ patients may also be contagious.The two methods have different significance for clinical diagnosis.