干扰素治疗慢性乙型肝炎病人HBV-DNA的实时FQ-PCR检测及其意义

①目的 探讨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）对干扰素（IFN）治疗慢性乙型肝炎（CHB）疗效预测及评价的价值。②方法 21例CHB病人，在治疗前、治疗过程中第1～6个月、疗程结束后随访6和12个月共9个时间点分别取血，用FQ-PCR定量检测HBV-DNA、放免法定量检测HBeAg。③结果 用药后第1～5个月，HBV-DNA载量逐月下降（H=137．50，q=4．68～14．04，P均〈0．01）;其后不再下降。治疗前血清HBV-DNA与HBeAg和谷丙转氨酶（ALT）呈高度正相关（r=0．719、0．492，P〈0．05），治疗期间及随访过程中各时间点HBV-DNA与ALT呈负相关（r=-0．259～-0．057，P〈0．05），与HBeAg呈低度正相关（r=0．014～O．138，P％0．05）。④结论 FQ-PCR以其高度的敏感性及简便、快速、准确而成为目前HBV-DNA定量检测的首选方法；在应用IFN治疗CHB前，应根据血清HBV-DNA拷贝数和其他预测因子慎重选择病例，可以明显提高疗效。

THE REAL-TIME FLUORESCENCE QUANTITATIVE PCR IN THE LABORATORY DIAGNOSIS OF CHRONIC HEPATITIS B TREATED BY INTERFERON

Objective To investigate the value of real-time fluorescence quantitative PCR (FQ-PCR) used in the prediction and evaluation of therapeutic effect of interferon (IFN) for chronic hepatitis B(CHB). Methods The blood samples of 21 CHB patients were taken for nine time points, i.e. prior to and 1,2,3,4,5,6 months in the course of treatment, and 6,12 months after the treatment. Hepatitis B virus DNA (HBV-DNA) was quantified with the FQ-PCR; HBeAg by the sandwich assay of radial immunity. Results HBV-DNA in the treated group decreased gradually month by month in the first five months after taking IFN( H=137.50,q=4.68-14.04,P <0.01),and did not decrease anymore afterward. The correlation between HBV-DNA and HBeAg, HBV-DNA and ALT was high before treatment (r =0.719 and 0.492, P <0.05). But negative correlation was found between HBV-DNA and ALT at each time point of treatment and follow-up ( r=-0.259--0.057,P <0.05), low correlation showed between HBV-DNA and HBeAg( r=0.014-0.138,P <0.05). Conclusion FQ-PCR is the first of choice for detection of HBV-DNA at present with its highly sensitive , convenient, accurate and timesaving. Before using interferon for CHB, one should cautiously select the patients based on the copies of HBV-DNA and other related factors so as to improve the efficacy.