荧光定量PCR检测乙型肝炎病毒的临床研究

目的 :建立荧光定量PCR检测HBV DNA的方法 ,探讨荧光定量PCR在乙型肝炎病毒检测方面的临床价值。方法 :采用荧光定量PCR技术 ,对不同类型乙型肝炎患者及无症状健康者血清HBV DNA进行定量检测。对30例慢性乙型肝炎拉米夫啶治疗前后血清HBV DNA含量进行定量监测。结果 :(1)血清HBV DNA的检出率与HBeAg阳性率呈正相关 ,无症状健康者仍有 3%的检出率。 (2 )慢性乙型肝炎和乙肝后肝硬化的血清HBV DNA含量明显高于无症状HBV感染者和急性乙型肝炎 (P <0 .0 1)。 (3) 30例慢性乙型肝炎 ,经拉米夫啶治疗 12个月 ,HBV DNA阴转率为 73.3% (2 2 / 30 ) ,明显高于HBeAg阴转率 (46 .2 % ) (P <0 .0 5 )。结论 :荧光定量PCR检测HBV DNA ,能直接反映血清HBV DNA含量 ,在判断体内HBV是否复制、复制的程度 ,HBV是否被清除以及HBV血清标志阴性肝炎的诊断等方面明显优于HBV血清标志物检测。荧光定量PCR检测HBV DNA是抗病毒治疗选择和考核抗病毒疗效的最直接最可靠的指标 ,具有重要的临床价值 ,值得推广应用

The Clinical Research on Detection of Hepatitis B Virus by Fluorescence Quatitative PCR

Objective: To set up a Fluorescence quatitative PCR assay(FQ PCR)to explore the clinical value of detecting the load of HBV DNA. Methods: FQ PCR technique was used to measure the loads of HBV DNA of the cases of hepatitis B and the cases of HBV antigen or antibody negative, and 30 cases of chronic hepatitis B treated with Lamivudine.Results:(1)The positive rate of HBV DNA was closely correlated to that of HBeAg,and there was 3% positive rate of the DNA in the cases of HBV antigen or antibody negative.(2)The loads of HBV DNA in patients with chronic hepatitis B or cirrhosis were significant higher than that in ones of HBV healthy carriers and in patients with acute hepatitis B( P <0.01).(3)The rate of HBV DNA turned to negative was 73.3%(22/30),but only 46.2% of HBeAg positive samples turned to negative( P <0.05)after 12 months treating with Lamivudine in 30 cases of chronic hepatitis B.Conclusion:FQ PCR was an accurate quatitative technique in detecting HBV DNA and it was significant better than ELISA technique in diagnosis of hepatitis B and selection of anti virus drugs.