PCR检测HBV感染患者血清HBV DNA的临床意义

目的探讨急、慢性乙型肝炎及与ＨＢＶ感染相关的肝硬变和肝癌患者血清ＨＢＶＤＮＡ的临床意义．方法应用ＰＣＲ技术检测不同ＨＢＶ感染２０５例，患者血清ＨＢＶＤＮＡ，并与正常人２０例作比较．结果ＨＢＶ感染患者２０５例血清ＨＢＶＤＮＡ阳性率为６９３％，慢性乙肝、乙肝后肝硬变和肝癌患者的阳性率分别为７６４％，７１９％和７００％，显著高于急性乙肝患者２１７％的阳性率（Ｐ＜００１）；ＨＢｅＡｇ（＋）患者血清ＨＢＶＤＮＡ阳性率为９３６％，显著高于ＨＢｅＡｇ（－）抗ＨＢｅ（＋）／（－）和ＨＢｓＡｇ（－）患者的阳性率（４５６％，２５０％和１２５％，Ｐ＜００１）；血清ＨＢＶＤＮＡ阳性和阴性两组患者的血清ＡＬＴ水平无明显差异（Ｐ＞００５）．结论血清中ＨＢＶＤＮＡ持续存在可能与乙型肝炎的慢性化有关，而与ＨＢＶ感染患者的肝损伤无明显关系

Detection of HBV DNA in serum of patients with HBV infection by polymerase chain reaction

AIM To study the clinical significance of HBV DNA detection in sera of patients with acute hepatitis B (AHB) and chronic hepatitis B (CHB) associated with liver cirrhosis (LC) and primary hepatocellular carcinoma (PHC). METHODS HBV DNA in sera of 205 patients with HBV infection was detected by polymerase chain reaction (PCR). RESULTS The positive rate of HBV DNA in the 205 cases of HBV infection was 69 3%. The positive rates of HBV DNA in patients with CHB (76 4%), LC (71 9%) and PHC (70 0%) were markedly higher than in patients with AHB (21 7%), ( P <0 01); and were significantly higher in patients with positive HBeAg (93 6%) than in patients with negative HBeAg, positive or negative anti-HBe and negative HBsAg (45 6%, 25 0% and 12 5%), ( P <0 01). There was no difference in the serum ALT levels between the patients with serum positive and negative HBV DNA ( P >0 05). CONCLUSION Chronicity of HBV infection might be correlated with the persitent existence of serum HBV DNA, but not significantly related to the liver damage of patients with HBV infection.