定量检测乙型肝炎病毒标志物与HBV DNA定量间的关系及临床意义

目的　探讨定量检测乙型肝炎病毒血清标志物(HBVM)与(HBV DNA)定量之间的关系及临床意义。方法　采用实时荧光定量PCR仪检测HBV DNA,采用时间分辨荧光免疫分析仪检测HBVM。结果　375例乙肝患者在HBV DNA含量分组中,随HBV DNA含量增高,HBs Ag、HBe Ag含量也增高,后两者与前者有良好的一致性,存在一定的相关性(r=0 .5 332 ,r=0 .380 9)。抗HBs,抗HBe及抗HBc与HBV DNA之间,无明显规律。HBs Ag含量:慢性轻度肝炎分别与急性肝炎、慢性重度、亚重肝、慢性重型肝炎,肝硬化比较差异有非常显著性(P<0 .0 1,0 .0 5或0 .0 0 1) ,HBe Ag含量:慢性轻度肝炎分别与急性肝炎、慢性中度、慢性重度、亚重肝、慢性重肝,肝硬化比较差异非常显著(P<0 .0 1或0 .0 0 1) ,HBs Ag含量及HBe Ag含量在其他临床分型中比较部分有统计学意义。HBV DNA阳性率及HBV DNA定量在部分临床分型中比较有统计学意义。结论　时间分辨荧光免疫(DEL FIA)是一敏感、特异方法,定量检测HBs Ag、HBe Ag能反映HBV DNA载量及复制情况;部分情况表明肝脏病变越重,其HBs Ag及HBe Ag血清含量越低,HBV DNA阳性率及HBV DNA载量与乙肝临床分型之间关系无确定性结论

The relationship between hepatitic B virus markers through quantity testing and HBV DNA quantity and their clinical significance

Objective To explore t he clinical significance and the relatio nship between the HBV DNA quantity and t he quantity testing of HBVM.Methods HBV DNA was tested with the real-time fluorescent quantitative PCR,and Hepatit is B virus markers with time-resolution immunofluorescence.Results In the 375 cases of Hepatitis B,the increase of the quantity of HBV DNA was followed by that of HBsAg and HBeAg,with the latter two fairly coherent and closely relevan t to the former(r=0.5332,r=0.3809).A nti-HBs,anti-HBe or anti-HBc is not rela ted to HBV DNA regularly.Quantity of HBs Ag:A remarkable difference between chron ic low-degree hepatitis B and acute he patitis B,chronic severe degree hepatiti s B,sub-severe hepatiti B,chronic severe hepatitis B,or hepatocirrhosis.Quantity of HBeAg:A remarkable difference betwee n chronic low-degree hepatitis B and acu t e hepatitis B,chronic mild degree hepati tis B,chronic severe degree hepatitis B, sub-severe hepatitis B,chronic severe he patitis B,or hepatocirrhosis(P<0.01,0. 05 or 0.001).The quantity of HBsAg and t hat of HBeAg for other clinical classifi cations illustrate statistical significa nce,and so is the case with parts of cli nical classifications in positive propor tion and quantity of HBV DNA.Conclusi o n Quantity testing of HBsAg/HBeAg wit h sensitive,special DELFIA can reflect t he quantity of HBVDNA and its copies.Par t of exploration shows that the severer a hepatic disease is,the lower the quant ity of blood s erum in HBsAg and HBeAg will be;No final conclusion can be drawn upon between th e positive proportion of HBVDNA,the quan tity of HBVDNA and clinical classificati ons of hepatitis B.