乙型肝炎病毒表面抗原在慢性乙型肝炎病毒感染后不同临床阶段的定量检测及临床意义

目的 测定慢性乙型肝炎病毒（HBV）感染后不同临床阶段患者血清乙型肝炎病毒表面抗原（HBsAg）定量,同时探究其与患者血清HBV DNA水平和年龄的相关性.方法 将未经抗病毒治疗的774例慢性HBV感染患者按照临床特征分为六组：慢性HBV携带组（102例）、非活动性HBsAg携带组（211例）、乙型肝炎病毒e抗原（HBeAg）阳性慢性乙型肝炎组（236例）、HBeAg阴性慢性乙型肝炎组（114例）、HBeAg阳性乙型肝炎肝硬化组（52例）、HBeAg阴性乙型肝炎肝硬化组（59例）,采用化学发光微粒子免疫分析法测定患者血清HBsAg定量,实时荧光定量聚合酶链反应法测定患者血清中HBV DNA定量,血清HBsAg和HBV DNA需要经常用对数转换后进行组间比较.结果 HBsAg定量由高到低分别为慢性HBV携带组、HBeAg阳性慢性乙型肝炎组、HBeAg阴性慢性乙型肝炎组、非活动性HBsAg携带组、HBeAg阴性乙型肝炎肝硬化组和HBeAg阳性乙型肝炎肝硬化组7.80（6.69 ～ 8.32）、7.11（5.42～8.27）、6.57（5.66 ～ 7.53）、6.38（4.39～ 7.40）、6.22（4.84～ 6.91）、6.13 （5.48～7.01）].HBeAg阳性慢性乙型肝炎组和HBeAg阴性慢性乙型肝炎组HBsAg定量与HBV DNA呈正相关（r=0.714和0.390,P＜0.01）.慢性HBV感染患者血清HBsAg的定量与年龄呈负相关（r=-0.416,P＜0.01）;监测年龄≥40岁非活动性HBsAg携带者的血清HBsAg定量有重要的临床价值.结论 慢性HBV感染后不同临床阶段患者血清HBsAg定量不同,血清HBsAg定量与患者HBV DNA水平和年龄相关,临床上应重点监测年龄≥40岁非活动性HBsAg携带患者血清HBsAg定量.

Hepatitis B virus surface antigen quantitative value in different stages of chronic hepatitis B virus infection

Objective To investigate hepatitis B virus surface antign （HBsAg） quantitative value quantitatively in serum of chronic hepatitis B virus （HBV） infection patients with different clinical stages,at the same time,to explore the correlation between HBV DNA,patient＇s age and HBsAg quantitative values.Methods Collected 774 cases without antiviral treatment of chronic HBV infection from our hospital,according to the clinical features,divided cases into six groups：chronic HBV carrier group （102 cases）,inactive HBsAg carrier group （211 cases）,hepativis B virus e antigen （HBeAg） positive chronic hepatitis B group （236 cases）,HBeAg negative chronic hepatitis B group （114 cases）,HBeAg positive hepatitis B cirrhosis group （52 cases）,HBeAg negative hepatitis B cirrhosis group （59 cases）.Used chemiluminescence immunoassay particles analysis to determine HBsAg quantitative value in serum in patients,used real-time fluorescent quantitative polymerase chain reaction method to determine HBV DNA quantitative value in patients,and then compared differences among groups.Results HBsAg quantitative value from high to low respectively were chronic HBV cartier group,HBeAg positive chronic hepatitis B group,HBeAg negative chronic hepatitis B group,inactive HBsAg carrier group,HBeAg negative hepatitis B cirrhosis group,HBeAg positive hepatitis Bcirrhosis group,the median quantitative value of HBsAg were 7.80 （6.69-8.32）,7.11 （5.42-8.27）,6.57 （5.66-7.53）,6.38 （4.39-7.40）,6.22 （4.84-6.91）,6.13 （5.48-7.01）] ; positive correlation was found between HBsAg quantitative value and HBV DNA in HBeAg positive chronic hepatitis B group and HBeAg negative chronic hepatitis B group （r =0.714,0.390,P 〈 0.01）; negative correlation was found between HBsAg quantitative value and age in chronic HBV infection（r =-0.416,P 〈 0.01） ; Monitored HBsAg quantitative value of inactive HBsAg carriers after the age 40 had important clinical value.Conclusions HBsAg quantitative value is differe