乙型肝炎患者血清HBV-DNA表达水平及其临床意义

摘要

目的探讨乙型病毒性肝炎患者血清HBV-DNA的表达水平及其与乙肝标志物的相互关系。方法用定性PCR法和定量PCR同步检测144例乙肝患者血清HBV-DNA，同时用ELISA法检测血清乙肝标志物。结果定性PCR与定量PCR HBV-DNA总体阳性率相同，均为78.47%(113/144)。乙肝患者血清HBV-DNA平均滴度(每毫升拷贝数)为4.3×103，其中急性肝炎、慢性肝炎轻度、慢性肝炎中度、慢性肝炎重度、肝炎后肝硬化者血清HBV-DNA平均滴度分别为2.7×103、6.7×102、2.5×105、6.9×105、9.9×104。相互比较，差异有显著性（P<0.01）。HBeAg(+)、HBeAg(-)患者血清HBV-DNA平均滴度分别为3.1×105、6.7×102，差异有显著性(P<0.01)。结论 HBeAg(+)患者血清中HBV-DNA水平高，定量PCR可更准确反映体内HBV增殖水平和传染性强弱。%Objective　To study the expression level of HBV-DNA in serum of patients with viral hepatitis B and its relation to hepatitis B virus marker (HBVM). Methods　The levels of HBV-DNA in serum of 144 patients with hepatitis B were detected by qualitative polymerase chain reaction (PCR) and quantitative PCR simultaneously, and the HBVM in serum was detected by ELISA simultaneously. Results　The positive rate of qualitative PCR and quantitative PCR was equivalent. The total average titers of HBV-DNA in serum was 4.3×103 copies/ml. Among them, the average titers in serum of acute hepatitis, chronic hepatitis (low-grade), chronic hepatitis (moderate), chronic hepatitis (high-grade), posthepatitic cirrhosis were 2.7×103 copies/ml, 6.7×102 copies/ml, 2.5×105 copies/ml, 6.9×105 copies/ml, 9.9×104 copies/ml respectively. There was significant difference among five groups (P<0.01). The average titers of patients with HBeAg(+) and HBeAg(-) were 3.1×105 copies/ml, 6.7×102 copies/ml respectively. There was a significant difference between them (P<0.01). Conclusion　The level of HBV-DNA in serum of HBeAg(+) is higher. The duplication level of HBV and the extent of its infection can be detected by quantitative PCR accurately.