乙肝患者HBV感染指标、病毒复制水平与基因分型的关系分析

摘要

目的 探讨HBV感染指标、病毒复制水平和基因型之间的关联及对乙肝患者诊断和预后的意义.方法 采用酶联免疫吸附试验(ELISA)检测样本的HBV PreS1-Ag、Anti-HBc-IgM和HBV两对半;荧光定量PCR法测HBV DNA水平;巢氏PCR法扩增S片段、测序并对比分析判定基因型,联合分析指标的关联.结果 收集河南地区急、慢性乙肝患者样本355例.模式Ⅰ(HBeAg阳性)的PreS1-Ag阳性率为80.2％、HBV DNA阳性率为73.7％,显著高于其他模式;PreS1-Ag、Anti-HBc-IgM阳性者的ALT、AST异常率显著高于阴性组;HBV基因型结果为B型4例(2.9％),C型76例(55.9％),D型56例(41.2％),C型患者的HBeAg和HBV DNA阳性率显著高于B型和D型.结论 PreS1-Ag和Anti-HBc-IgM对乙肝早期诊断、病毒复制监测及预后评估有重要意义;河南地区乙肝患者的HBV基因型以C型和D型为主,C型的HBeAg和HBV DNA阳性率显著高于B和D型.%Objective To explore the relationship of HBV PreS1 antigen,anti-HBc IgM,DNA load and genotypes,and the significance for clinical diagnosis and prognostic.Methods Enzyme linked immune-sorbent assay was used to test the HBV serum markers of HB patients; HBV-DNA copies was detected by time fluorescence quantitative PCR; using nested PCR to amplify the S fragment of HBV genome,then sequenc and make blast with HBV standard sequences to ascertain genotypes.Make comprehensive analysis of these indexes.Results 355 serum specimens of acute or chronic HB patients were collected.The positive rates of HBV PreS1-Ag and HBV-DNA in model Ⅰ (positive for HBeAg) were 80.2％ and 73.7％ respectively,which both higher than other models.The abnormal rate of ALT and AST were higher in PreS1-Ag positive group than negative,as well as in anti-HBc IgM positive group.There are 4 samples is genotype B (2.9％),76 genotype C(55.9％) and 56 genotype D (41.2％).Positive rate of HBeAg and HBV-DNA of genotype C samples were both higher than which of genotype B and D.Conclusion PreS1-Ag and Anti-HBe-IgM indexes are of great value to viral hepatitis B early diagnosis,HBV replication surveillance and prognostic evaluation; the major HBV genotypes in Henan province are C and D,and the positive rate of HBeAg and HBV-DNA were both higher in genotype C HBV infection population than genotype B and D.