摘要
目的 研究乙型肝炎肝硬化终末期患者肝移植后外周血单个核细胞（PBMC）HBV DNA状态及临床意义。方法 应用荧光PCR技术检测乙型肝炎肝硬化终末期肝移植术后30例患者血清及PBMC标本HBV DNA，并用细胞计数法和管家基因β-actin标定PBMC HBV DNA，观察PBMC HBV DNA与血清HBV DNA定量关系；观察患者肝移植术后不同时间PBMC HBV DNA水平。30例对照组为肝炎肝硬化失代偿期患者。结果 移植后患者19份（63％）PBMC标本HBV DNA阳性，低于对照组（87％，26／30）。以C1值为定量参数，移植后患者PBMC HBV DNA水平显著低于对照组（P=0．02）；肝移植术后患者PBMC HBV DNA长期维持于10^3～10^4拷贝，106细胞水平，与肝移植后时间无明显关系。移植后患者血清HBV DNA均阴性，而对照组血清阳性率为48％。结论乙型肝炎肝硬化终末期患者肝移植术后，经有效预防HBV再感染治疗后，虽然血清中不能测出HBV DNA，但PBMC中HB VDNA阳性，这可能成为肝外“病毒池”，导致供肝再感染；对移植后患者监测PBMC HBV DNA，可能有助于早期诊断HBV再感染或复发。
Objective To evaluate the state of hepatitis B virus in the peripheral blood mononuclear cells（PBMCs） of post- liver-transplantation patients. Methods PBMCs and serum were collected from 30 post-liver-transplantation patients, and HBV DNA in serum and PBMCs was quantified by specific fluorescence real-time PCR. The level of HBV DNA in PBMCs was standardized by cell counting and internal control of house-keeping gene （β-actin）, and its dynamics after liver transplantation were analyzed. Another 30 patients with decompensated liver cirrhosis with hepatitis B were served as control. Results HBV DNA was detected in PBMCs of 19 post-liver-transplantation patients （63%）, comparing to a relatively higer positive rate （87%, 26/30）in control group. The level of HBV DNA in the PBMCs of post-liver-transplantation patients was significantly lower than that of control group （ P = 0.02）, fluctuated in a range of 10^3 - 10^4 copies/106 cells, and had no definite relation with the post-operative time. HBV DNA was undetectable in serum of post-liver-transplantation patients, while it was positive in 47% patients （14/30）of control group. Conclusion HBV might exist in PBMCs of post-liver-transplantation patients associated with hepatitis B, even when no detectable HBV DNA was observed in the serum under ＂effective＂ measure, might still serves as one of the sources of HBV reinfection of the graft liver. Detection of HBV DNA in PBMCs may give us an signal of the HBV reinfection than monitoring HBV in serum after liver transplatation.
出处
《肝脏》
2006年第3期152-153,169,共3页
Chinese Hepatology
关键词
乙型肝炎病毒
肝移植
外周血单个核细胞
实时荧光PCR
Hepatitis B virus
Liver transplantation
Peripheral blood mononuclear cell
Real-time fluorescence PCR
