HBV-M与HBV-DNA的定量关系探讨

目的:探讨时间分辨荧光免疫分析法(TRFIA)检测乙型肝炎患者血清免疫标志物(HBV-M)与实时荧光定量聚合酶链反应(FQ-PCR)定量检测乙型肝炎病毒DNA(HBV-DNA)含量之间的关系。方法:采用FQ-PCR技术检测239例患者血清中HBV-DNA含量,同时用TRFIA检测乙型肝炎病毒五项标志物及含量,并对各项检测结果进行统计学分析,同时以HBV-DNA拷贝数的对数为横坐标,HBV-M含量的对数为纵坐标,求线性回归及相关系数(r)。结果:239例乙肝患者血清中,HBV-DNA的阳性率与HBV-M不同组合之间有差异,HBsAg+/HBeAg+/HBcAb+组HBV-DNA的阳性检出率明显高于其它组,达96.33%(105/109),HBsAg+/HBeAb+/HBcAb+组为43.90%(54/123),HBsAg+/HBcAb+组为42.86%(3/7)。并且随HBsAg、HBeAg含量增高,HBV-DNA含量也增高,存在一定的相关性(r=0.364,r=0.536)。抗-HBs,抗-HBe及抗-HBc与HBV-DNA之间,无明显相关性。结论:HBeAg阳性是病毒复制的重要指标;抗-HBe的出现不能作为HBV复制停止的指标;HBsAg、HBeAg浓度与HBV-DNA之间有良好的相关性,HBsAg和HBeAg浓度变化可以作为临床评价乙肝病毒复制程度和抗病毒疗效的参考指标;联合采用TRFIA检测HBV-M与FQ-PCR定量检测HBV-DNA能更早的诊断HBV感染,了解病毒的复制情况和观察疗效及判断预后。

Exploring the Relation between HBV-M Detected by TRFIA and HBV-DNA Detected by FQ-PCR

Objective To explore the relation between the HBV serum markers and the quantity of HBV-DNA.Methods In sera of 239 patients,HBV-DNA was detected by florescence quantitative PCR(FQ-PCR),while HBV-M was detected by time-resolved fluorescence immunoassay(TRFIA).Results In 109 cases of HBsAg / HBeAg / HBcAb ,105 cases were also FQ-PCR positive,with a positive rate of 96.33%.In 123 cases of HBsAg / HBeAb / HBcAb ,54 cases were also FQ-PCR positive,with a positive rate of 43.90%.In 7 cases of HBsAg / HBcAb ,3 cases were also FQ-PCR positive,with a positive rate of 42.86%.In the 239 cases of Hepatitis B,the increase of the quantity of HBV-DNA was followed by that of HBsAg and HBeAg,and with the latter two fairly coherent and closely relevant to the former(r=0.364,r=0.536).Anti-HBs,anti-HBe or anti-HBc is not related to HBV-DNA regularly.Conclusion The HBeAg is positive can be take as a important indicator of HBV replication.the appearance of anti-HBe can not be take as indicator of ceasing of HBV replication.There is a close relationship among HBsAg,HBeAg and HBV-DNA,the changes of HBsAg,HBeAg can be used as clinical evaluation in HBV replication.It is very important to monitor the HBsAg,HBeAg and HBV-DNA together for the diagnosis of HBV infection in earlier stage,the investigation of reproduction,therapeutic observation and prognosis.