慢性乙肝患者血清cccDNA临床相亲性研究

目的探讨慢性乙型肝炎患者血清HBV cccDNA与血清AST、ALT及血清HBV—DNA之间关系。方法应用实时荧光定量聚合酶链反应（FQ-PCR）技术检测慢性乙型肝炎患者血清HBV cccDNA及HBV—DNA水平。结果91例乙肝患者中血清ALT、AST异常的分别有79例、59例，检出HBV cccDNA阳性的分别有53例、41例，检出率分别为67．09％、69．49％，检出率与正常组相比有统计学意义（P=0．001〈0．05，P=0．015〈0．05）；血清HBV cccDNA在HBV-DNA复制水平〈10^4 copies／mL时检出率为11.11％，HBV-DNA复制水平10^4-6 copies／mL时检出率为53．33％，HBV—DNA复制水平〉10^6 copies／mL时检出率为86．05％，以上不同的HBV—DNA复制水平血清HBV cccDNA检出率相比差异有统计学意义（P=0．000〈0．05）。结论血清HBV cccDNA检出率与血清HBV—DNA水平及血清ALT、AST水平有明显正相关性，血清HBV cccDNA的动态检测可以作为临床治疗及监测的一个重要参考指标。

The clinical research on relationship between serum cccDNA and other related indicators in patients with chronic hepatitis B

Objective To study the relationship between serum HBV covalently closed-circular DNA(cccDNA)and other related serum indicators(AST,ALT and HBV-DNA)in patients with chronic hepatitis B.Methods Real-time fluorescence quantitative polymerase chain reaction(FQ-PCR)was applied to measuring the serum levels of HBV cccDNA and DNA in 91 patients with chronic hepatitis B.Results In 91 cases of chronic hepatitis B,79 cases were ALT abnormal,in which 53 cases were HBV cccDNA positive(53/71,67.09%);59 cases were AST abnormal,in which 41 cases were HBV cccDNA positive(41/59,69.49%).There was statistical difference in detection rate of HBV cccDNA between hepatitis group and healthy control group(both P＜0.05).The detection rate of serum HBV cccDNA was closely associated with the replication level of HBV DNA(P＜0.05).When HBV-DNA level was less than 104 copies/mL,the detection rate of serum HBV cccDNA was 11.11%;104～106 copies/mL,53.33%;higher than 106 copies/mL,86.05%.Conclusion The detection rate of serum HBV cccDNA is positively correlated to serum levels of AST,ALT and HBV-DNA.Serum HBV cccDNA can be used as an important indicator of clinical treatment and therapeutic effect monitoring of chronic hepatitis B.