摘要
目的 探讨乙型肝炎病毒 (HBV)感染者乙型肝炎病毒脱氧核糖核酸 (HBV DNA)定量检测的临床意义 ,以及与乙型肝炎血清学e系统 (HBe)标志、丙氨酸转氨酶 (ALT)和天冬氨酸转氨酶 (AST)水平的相关性。方法 采用荧光标记探针定量聚合酶链反应 (PCR)技术、酶联免疫吸附测定法及速率法 ,对 14 0例乙型肝炎病毒感染者乙型肝炎病毒血清DNA含量、血清学标志、ALT和AST进行检测 ;同时动态检测了 2 0例乙肝患者 2 4周拉米夫定治疗期间的血清HBe标记系统和HBV DNA含量变化。结果 e抗原 (HBeAg)阳性组的HBV DNA含量 (M =6 .4 8)显著高于e抗体 (HBeAb)阳性组的HBV DNA含量 (M =4 .2 8) ,差异有统计学意义 (H =2 8.4 8,P <0 .0 0 1) ;不同临床类型乙肝患者的HBV DNA含量检测结果之间的比较 ,差异无统计学意义 (H =2 .181,P >0 .0 5 ) ;在拉米夫定治疗期间 ,血清HBV DNA含量的下降和转阴明显先于血清学标志系统的转换。结论 HBeAg是反映HBV DNA复制的重要指标 ,HBeAg阳性表示乙型肝炎病毒复制活跃 ,但在抗病毒治疗期间 ,血清学标志指标反映HBV复制状态存在局限性 ,HBV DNA定量检测是反映HBV复制和判断药物疗效的最直接、可靠的指标 ;乙型肝炎患者病程的变化。
Objective To evaluate the clinical significance of quantitative detection of hepatitis B virus DNA and investigate the correlation between HBV-DNA quantity and HBV serological marker, level of AST and ALT, respectively. Methods The level of HBV-DNA, HBV marker, AST and ALT from 140 serum samples with HBV infection were detected by fluorescence-labeled TaqMan DNA probe quantitative PCR and ELISA, chemical analysis respectively, in addition to 20 patients with HBV infection who were treated with lamivudine and followed with the measurement mentioned above. Results The level of HBV-DNA in HBeAg positive group (M= 6.48) was significantly higher than that in the patients with HBeAb positive(M= 4.28)group(H= 28.48, P< 0.001); No difference was found among the infected patients with various liver impairment; obvious reduction of HBV-DNA occurred in some patients receiving lamivudine treat,which was earlier than HBeAg negative reversion. Conclusion HBeAg is an important index for HBV-DNA duplication,HBeAg positive represents active duplication of hepatitis B virus,but in anti-virus therapy,serological HBV markers reflect a limitation on the duplication and quantitative detection HBV-DNA is a direct, reliably index. There was no significant relation between the level of HBV-DNA and the state of liver impairment; there was no correlation between replication of HBV and the level of ALT and AST.
出处
《临床荟萃》
CAS
北大核心
2003年第18期1025-1027,共3页
Clinical Focus
