不同临床时期乙型肝炎病毒感染者血清病毒核糖核酸水平的比较

摘要

目的：观察和分析慢性 HBV 感染者不同临床时期的血清乙型肝炎病毒核糖核酸（HBV RNA）、HBV DNA以及 HBsAg 水平。方法入组86例慢性 HBV 感染者，抽提血清 HBV RNA 并以 Oligo（dT）为引物反转录 mRNA 为cDNA，Taqmen 荧光定量 PCR 法检测 cDNA。将慢性 HBV 感染者不同临床时期的测定结果进行统计分析。结果血清HBV RNA 定量在免疫耐受期、免疫清除期、再活动期、非活动或低（非）复制期患者中依次降低，不同临床时期血清 HBV RNA 水平两两比较均差异有统计学意义（P ＜0．05）。在慢性 HBV 感染者中，血清 HBV RNA 与 HBV DNA 呈正相关（HBeAg 阳性，r＝0．523，P ＝0．004；HBeAg 阴性，r＝0．340，P ＝0．034）。血清 HBV RNA 水平与 HBsAg 水平均呈正相关（HBeAg 阳性，r＝0．548，P ＜0．01；HBeAg 阴性，r ＝0．317，P ＝0．049）。结论随着慢性 HBV 感染病程的进展，血清HBV RNA 水平逐渐下降。且血清 HBV RNA 水平与 HBV DNA、HBsAg 水平呈正相关。%Objective To investigate the correlation of serum hepatitis B virus(HBV)RNA,HBV DNA and HBsAg levels in patients with hepatitis B. Methods Eighty-six patients with persistent HBV-infection were enrolled.For measurement of serum HBV RNA,total nucleic acid was extracted from serum samples and treated with RNase-free DNase I.After cDNA synthesis from extracted RNA,HBV RNA was measured by real-time PCR.The first strand of cDNA was synthesized with an oligo (dT)primer.Results Serum HBV RNA levels reduced sequentially from immune tolerance phase,immune clearance phase,reactivity phase,to inactivity phase,and the difference between any two phases was statistically significant (P < 0.05).Furthermore,we found positive correlation between serum HBV RNA and HBV DNA in patients with persistent HBV-infection (HBeAg positive,r = 0.523,P = 0.004,HBeAg negative,r = 0.340,P = 0. 034).There were also positive correlations between serum HBV RNA and HBsAg (HBeAg positive,r=0.548,P <0.001 , HBeAg negative,r= 0.317,P = 0.049).Conclusion As the progression of persistent HBV-infection,seurm HBV RNA levels presented the gradually decreasing tendency.Our results confirmed a strong positive correlation between serum HBV RNA and HBsAg,serum HBV RNA and HBV DNA levels in patients with persistent HBV-infection.