乙型肝炎复制与感染指标的相关性及各指标在肝病防治中的应用  

Relativity and Role of Hepatitis B Replication and Infection Marks in Preventing and Curing Hepatopathy

作　　者：陈然峰[1] 陈国军[1] 董长林[1] 黄晓文[1] 陈孟春[1] 

机构地区：[1]武警浙江省总队医院,浙江嘉兴314000

出　　处：《中华医院感染学杂志》2004年第10期1084-1086,共3页Chinese Journal of Nosocomiology

摘　　要：目的　探讨乙型肝炎复制指标HBVDNA、HBeAg、HBcAg、Pres1Ag、HBcAb和感染指标PHSA Re的相互关系及其在肝病防治中的应用价值。方法　对 2 6 8例乙型肝炎血清分别采用荧光探针技术定量PCR法测定HBVDNA浓度、固相放射免疫法检测HBcAg和PHSA Re以及酶免法测定Pres1Ag和HBVM ,并进行结果比较分析。结果　 5项复制指标分别在HBVM不同模式组检出率不等同 ;HBcAb( + )组的HBVDNA和HBcAg阳性率显著高于HBcAb( - )的HBVM模式组 (P <0 .0 1) ;若以HBVDNA检测阳性为HBV复制金标准 ,HBcAg检测符合率 ( 83 2 % )显著高于其他指标 (P <0 .0 1) ,而HBcAb检测特异性和HBeAg检测灵敏度过低 ;在 15 8例HBVDNA阳性和 110例HBVDNA阴性的乙型肝炎血清中 ,PHSA Re的阳性率分别为 96 8%和 38 2 % ,HBVDNA的含量与PHSA Re浓度呈正相关递增。结论　HBcAg与HBVDNA相关性最好 ,HBcAb仅仅可作为HBV复制的初筛指标 ,5项指标评价HBV复制的临床意义为 :HBVDNA >HBcAg>Pres1Ag >HBcAb ;HBVDNA阴性乙型肝炎患者HBV的复制和感染仍有并存 ,乙型肝炎指标联合检测在肝病防治中更能客观反映HBV复制与感染程度。OBJECTIVE To investigate the relationship and the role of HBV DNA, HBeAg, HBcAg, Pres 1Ag, HBcAb and PHSA Re in preventing and curing hepatopathy. METHODS Contents of serum HBV DNA, HBcAg and PHSA Re, Pres 1Ag and HBV M in 268 patients with hepatitis B were determined by PCR fluorescence quantity, solid phase radioimmunoassay and enzyme immunoassay respectively. RESULTS Positive rates of five replication parameters in different HBV M groups had obvious difference. The positive rates of HBV DNA and HBcAg in the HBcAb(+) groups were higher than that in the HBcAb(-) groups (P<0.01). Taking HBV DNA(+) for the gold standard of HBV replication, the effective rate of HBcAg was higher than that of other indexes(P<0.01). However, the specificity of HBcAb and the sensitivity of HBeAg were too low. The positive rates of serum PHSA Re were 96.8% and 38.2% in 158 cases with positive HBV DNA and 110 cases with negative HBV DNA respectively. The increased PHSA Re concentrations were positively correlated with HBV DNA contents. CONCLUSIONS The relationship between HBcAg and HBV DNA is the best. HBcAb is regarded as the primary election index of HBV replication. The clinical estimation of five replication marks: HBV DNA > HBcAg>Pres 1Ag>HBeAg>HBcAb. Infection and replication of hepatitis B virus in patients with negative HBV DNA still coexisted, and combined determination of the hepatitis B parameters can reflect objectively the degree of replication and infection in preventing and curing hepatopathy.

关 键 词：乙型肝炎 乙型肝炎复制指标 乙型肝炎感染指标 应用评价 

分 类 号：R512.62[医药卫生—内科学]