超敏系统检测低拷贝 HBV DNA 定量的临床意义

摘要

目的：探讨超敏 HBV DNA 定量检测的低拷贝结果与 HBV 标志物和肝功能主要指标的相关性。方法同时检测283例 HBV DNA ≤1000 IU ／mL 低拷贝的乙型肝炎患者的5项肝功能指标，并进行组间比较。结果乙型肝炎病毒定量低拷贝的患者 HBV 标志物中 HBV e 抗原（HBeAg）差异有统计学意义（χ2＝5．310，P＝0．021）；HBV e 抗体（HBeAb）差异无统计学意义（χ2＝1．266，P＞0．05）；126例小三阳患者中，HBV DNA 定量结果在20及20～103 IU ／mL 55．56％；117例大三阳患者中，HBV DNA 定量检测结果阴性21．37％；肝功能指标谷氨酸氨基转移酶（AST ）、丙氨酸氨基转移酶（ALT ）、碱性磷酸酶（ALP）异常率分别为15．90％、8．13％、13．78％。结论乙型肝炎5项定量结果低或经抗病毒治疗后的患者，临床应采用超敏系统检测 HBV DNA 定量，同时结合乙型肝炎5项定量与肝功能，更好地了解病毒复制情况和肝细胞损害程度，为治疗提供可靠的临床依据。%Objective Analysis of the relationship of low copy HBV‐DNA results using hypersensitive quantitative system and HBV markers or liver function indexes ,and investigate the clinical application value .Methods Hepatitis B virus antigens and anti‐bodies and liver function indexes were detected in the total of 283 chronic hepatitis B virus patients (CHB) with low HBV DNA cop‐ies(less than or equal to 1 000 IU /mL copies) and the data were compared and analyzed .Results HBeAg in patients with low quantitative hepatitis B virus copies showed significant diffenence by chi square test (χ2 = 5 .310 ,P< 0 .021) .But HBeAb showed no statistical significance by chi square test (χ2 = 1 .266 ,P> 0 .01) .HBV DNA quantitative results in 20 and 20 - 103 low copy range accounted for 55 .56% in 126 cases of small patients without HBeAg (Small Sanyang patients) ,and HBV DNA negative results ac‐counted for 21 .37% in 117 cases of patients with HBeAg (Big Sanyang patients) .Furthermore ,abnormal rates of liver function in AST ,ALT and ALP were 15 .90% ,8 .13% and 13 .78% respectively .Conclusion Combination of hypersensitive detection of ser‐um HBV DNA copies and quantitative liver function in low‐copy patients or patients after antiviral therapy will be of better clinical value ,contribute to better understand of viral replication and liver cell injury and provide a reliable basis for treatment .