乙型肝炎表面抗原/抗体同时存在的血清学模式与病毒血症的关系

目的分析乙型肝炎病毒（HBV）感染者乙肝表面抗原（HBsAg）与乙肝表面抗体（HBsAb）同时阳性的模式,与HBV DNA的关系,以及其产生的原因及临床意义。方法采用化学发光微粒子免疫分析法（CMIA）检测样本的HBV血清标志物,从中选出HBsAg和HBsAb同时阳性的样本,采用荧光定量聚合酶链反应（FQ-PCR）检测其HBV DNA定量值。结果在选取的HBsAg和HBsAb同时阳性的37例样本中,出现3种HBV模式：（1）HBsAg、HBsAb、HBeAb、HBcAb阳性,阳性率46%,HBV DNA阳性率22%;（2）HBsAg、HBsAb、HBeAb、HBcAb阳性,阳性率30%,HBV DNA阳性率30%;（3）HBsAg、HBsAb、HBeAb、HBcAb阳性,阳性率24%,HBV DNA阳性率5%。37例样本中,有21例血清HBV DNA检测阳性,阳性率为57%。结论 HBsAg和HBsAb同时阳性并不代表疾病真正好转,部分感染者仍存在病毒血症,应当引起重视。

Analysis the Relationship beween Viremia and the Serum Marker Models of Hepatitis B with both HBsAg and HBsAb Positive

Objective To analyze of HBV marker model with both HBsAg and HBsAb positive in the sea of patients with Hepatitis B virus infection and the relationship with HBV DNA.Methods To test the serum HBV markers of the patients by chemiluminescent microparticle immunoassay（CMIA）,to choose the samples with both HbsAg and HBsAb positive among them.And to test HBV DNA quantitative by fluorescence quantitative polymerase chain reaction（FQ-PCR）.Results Among the 37 cases samples with both HBsAg and HBsAb positive,there were three HBV models：（1）HBsAg、HBsAb、HBeAb、HBcAb positive,the positive rate was 46%,HBV DNA positive rate was 22%;（2）HBsAg、HBsAb、HBeAb、HBcAb positive,the positive rate was 30%,HBV DNA positive rate was 30%;（3）HBsAg、HBsAb、HBeAb、HBcAb positive,the positive rate was 24%,HBV DNA positive rate was 5%;totally there were 21 cases of positive detection of serum HBV DNA,the positive rate was 57%.Conclusion It doesn＇t represent the disease really recovery that Hepatitis B patients with both HBsAg and HBsAb positive,some patients still come down with viremia,for it should be pay more attention.