摘要
目的 :探讨乙肝患者的不同血清学模式与血清乙肝病毒核酸 ( HBV DNA)含量关系及其临床意义。方法 :采用 EL ISA和定量 PCR方法检测 78例乙肝患者的血清乙肝病毒标志物 ( HBVM)和 HBV DNA含量 ,并将 HBVDNA含量和患者肝功能中的主要指标进行相关性分析。结果 :78例乙肝患者的 HBV DNA阳性率为 83 .3 % ( 65 / 78) ,65例阳性患者的血清 HBV DNA含量平均为 5 .78± 1.12 (对数值 ) ;慢性乙型肝炎和活动性乙型肝炎肝硬变患者的血清 HBV DNA含量显著高于急性乙型肝炎患者 ( P<0 .0 1) ;HBe Ag或 HBs Ag阳性组的 HBV DNA含量均显著高于HBe Ag或 HBs Ag阴性组 ( P<0 .0 1或 P<0 .0 5 ) ;在出现 HBe Ab血清转换组中 ,HBV DNA阳性率高达 77.8%～ 78.6% ;血清 HBV DNA含量与血清谷丙转氨酶 ( AL T)水平无相关性 ( r=0 .0 2 5 ,P>0 .0 5 ) ,但与血清总胆红素水平呈正相关 ( r=0 .3 0 3 ,P<0 .0 5 )。结论 :HBV慢性持续感染可能与病毒复制活跃及病毒变异等因素有关 ;慢性乙肝患者在出现 HBe Ab血清转换时 ,并不表示病毒复制停止 ,而只是病毒复制水平降低 ;乙肝患者的肝损害与
objective:To study the relationship between the different serum model in the patients of hepatitis B and the amount of serum HBV DNA and their clinical significances.Methods:The serum markers of HBV and the amount of HBV DNA were detected by ELISA and quantitative PCR in 78 cases of hepatitis B, and the relative analysis about the amount of HBV DNA with some main index of liver function were done.Results:The positive rate of HBV DNA was 83.3% in 78 cases of hepatitis B. Average amount of serum HBV DNA was 5.78±1.12 (value of logarithm) in 65 positive cases. The serum concentration of HBV DNA in the patients of chronic hepatitis B and active hepatitis B with liver cirrhosis were obviously higher than those in acute hepatitis B (P<0.01). The amount of HBV DNA in the positive cases of HBeAg or HBsAg were all obviously higher than those in the negative cases (P<0.01 or 0.05). HBV DNA positive rates were high to 77.8-78.6% in changing cases of serum HbeAb. The amount of serum HBV DNA was not related to ALT levels (r=0.025, P>0.05), but was related to TBI (r=0.303,P<0.05).Conclusion:The chronic lasting infection of HBV may be related to the active replication and mutation of virus. The serum changing of HbeAb don't means that virus copies stop, but only means that virus copies reduce in chronic cases of hepatitis B. The liver damage in the patients of hepatitis B was related to HBV copies to some extent.
出处
《南通医学院学报》
2003年第2期155-157,共3页
ACTA Academiae Medicinae Nantong
