慢性乙型肝炎血清、唾液HBV-DNA与肝组织HBcAg间关系的分析  

Examination of Association Between the HBV-DNA in Serum and Saliva and the Hepatic HBcAg in Chronic Hepatitis B: Its Clinical Significance

作　　者：潘红英[1] 谌翠容[1] 张永乐[1] 王洁[1] 李冰茹[1] 卢德荣[1] 娄国强[1] 施军平[1] 

机构地区：[1]杭州市第六人民医院,310014

出　　处：《医学研究杂志》2007年第6期44-46,共3页Journal of Medical Research

基　　金：杭州市科技发展计划项目(2003133B36)

摘　　要：目的探讨慢性乙型肝炎(CHB)患者血清、唾液HBV-DNA水平与肝组织HBcAg间关系及其临床意义。方法前瞻性分析200例慢性乙型肝炎患者采用荧光聚合酶链反应(FQ-PCR)精确定量配对检测血清、唾液中HBV-DNA含量;同时进行肝活体组织检查,采用免疫组化技术分析肝组织HBsAg,HBcAg。按血清logHBV-DNA水平将CHB患者分为5组。结果各组血清HBV-DNA与肝组织免疫组化检测HBsAg、HBcAg阳性者之间分析具有显著差异(P<0.01)并呈正相关(分别为r=0.55,0.80;P<0.001);分组唾液HBV-DNA水平与肝组织免疫组化HBsAg阳性者之间差异无显著性(P=0.07),而唾液HBV-DNA与HBcAg之间则有明显差异(P<0.001),并呈显著正相关(r=0.41,P<0.001)。血清、唾液HBV-DNA水平间呈正相关(r=0.73,P<0.01)。结论慢性乙型肝炎患者唾液HBV-DNA水平与肝组织HBcAg阳性者之间差异具有显著性及正相关,提示检测唾液HBV-DNA与肝细胞内HBcAg具有明确的一致性。首次同时检测唾液HBV-DNA及HBcAg可能对慢性乙型肝炎诊断及疗效观察具有重要影响。Objective This study aims at analyzing relationships between the HBV - DNA in serum,saliva and the hepatic HBcAg in patients with chronic hepatitis B （ CHB ） and understanding its clinical significance. Methods Study was designed prospectively. Fluo- rescence quantitative PCR （FQ -PCR）, which combines PCR with fluorescence probe hybridization, was used to precisely determine HBV - DNA in serum, saliva of the 200 patients with CHB. Hepatic biopsy was performed and tissue samples were analyzed with immunohistochemistry staining. The CHB patients were divided into 5 groups, based on their HBV - DNA levels transformed by logarithm. Resuits The result showed that HBV - DNA levels in serum associated closely with either hepatic HBsAg（ ＋ / - ） or HBeAg（ ＋ / - ） （ r = 0.55, 0.80 ;P 〈 0. 001 ）; HBV- DNA levels in saliva, however, was only correlated well with hepatic H BeAg（ ＋/- ）（ r = 0.41, P 〈 0. 001 ） ; but with hepatic HBsAg. （r = 0.06, P 〉 0.05）. Positive correlations of HBV- DNA were also found between serum and saliva （ r = 0. 73,P 〈 0. 001 ）. Conclusions An existence of positive close association of saliva HBV - DNA with hepatic HBcAg suggests their consistency in patients with CHB. Combined measurements of saliva HBV - DNA with hepatic HBeAg at baseline may help CHB diagnosis reasonably and monitor response efficiently to antiviral therapy.

关 键 词：慢性肝炎 乙型 HBV—DNA 血清 唾液 HBsAg HBCAG 

分 类 号：R512.62[医药卫生—内科学]