唾液乙型肝炎病毒检测在预防乙型肝炎传播中的意义  

The roles of saliva testing for preventing hepatitis B virus spreading

作　　者：张永乐[1] 潘红英[1] 谌翠容[1] 娄国强[1] 叶荣夏[1] 卢德荣[1] 

机构地区：[1]杭州市第六人民医院临床实验室,310014

出　　处：《中华预防医学杂志》2008年第8期596-598,共3页Chinese Journal of Preventive Medicine

基　　金：基金项目：杭州市科技局科研项目（2003133836）获杭州市2007年科技局科技进步三等奖

摘　　要：目的探讨乙型肝炎（简称乙肝）患者唾液中乙肝病毒（HBV）含量在乙肝传播中的意义。方法采用荧光定量聚合酶链反应检测200例乙肝患者和20例健康体检者的血清、唾液中HBVDNA含量。按血清乙肝病毒含量高低分为4组，即对照A组、阴性B组、低病毒C组[1×10^3～1×10^4拷贝／ml（copies／ml）]、高病毒D组（〉1×10^5copies／ml）。分析唾液与血清病毒含量之间的关系。结果200例乙肝患者血清中检出HBVDNA 180例，阳性率为90．0％，而唾液中检出HBVDNA 145例，阳性率为72．5％，两者比较差异没有统计学意义（χ^2=1．35，P〉0．05）。低病毒C组血清与唾液检出病毒（100．0％vs38．5％）两者比较差异具有统计学意义（χ^2=14．11，P〈0．01）。高病毒D组血清与唾液检出病毒（100．％vs83．8％）两者比较差异没有统计学意义（χ^2=1．05，P〉0．05）。血清高病毒D组病毒平均含量为（6．63±1．55）log copies／ml（拷贝／ml的常用对数），唾液中病毒平均含量为（5．21±1．85）log copies／ml，唾液较血清病毒含量平均低一个数量级。20例健康体检者血清和唾液中未检出HBV DNA。结论乙肝患者血清中含有较高的HBV DNA病毒时，其唾液中也存在具有感染性的HBV DNA病毒，可能成为传染源之一。精确检测唾液中HBV DNA水平可评价病毒在体内复制程度，进而判断患者的传染力度。Objective To discuss the significance of testing hepatitis B virus （HBV） from saliva in HBV patients. Methods HBV DNA content in serum and saliva of 200 HBV patients and 20 healthy subjects were detected by fluorescence quantitative polymerase chain reaction. According to the serum level of HBV content, four groups were divided ： control group A, group B negative, low virus C （ 1 × 10^3 - 1 × 10^5copies/ml） and high-group D （ 〉 1 × 10^5copies/ml）. The relationship of serum and virus content in saliva was analysed. Results Of 200 HBV cases, 180 were found HBV DNA in serum with positive rate of 90.0% ;while 145 were found HBV DNA in saliva with positive rate of 72. 5 %, and there was no significant difference （χ^2 = 1.35, P 〉 0. 05 ）. The significant difference was observed in testing serum and saliva in Group C （ 100.0% vs 38.5% ;χ^2= 14. 11,P 〈 0. 01 ）. In group D, there was no significant difference found either （ 100.0% vs 83.8% ; χ^2 = 1.05, P 〉 0. 05 ）. Group D virus serum had a high average level of （6. 63 ± 1.55 ） log copies/ml virus and in the saliva had an average level of（ 5.21 ± 1.85 ） log copies/ml ; saliva had serum viral load lower than an order of magnitude average. No HBV DNA was found in serum or saliva from 20 health subjects. Conclusion When the serum contains a high content of HBV DNA virus, the content of saliva HBV DNA virus should be likely high, which might pose a threat of source of infection. A precise quantitative detection of HBV DNA in saliva might be used as evaluation of the level of virus in the body copy for judgment of infection.

关 键 词：唾液 肝炎病毒 乙型 血清学试验 对比研究 

分 类 号：R686[医药卫生—骨科学]