慢性乙肝患者血清HBV DNA与HBeAg定量及ALT水平的相关性分析及临床意义  

Correlation analysis between hepatitis B virus DNA with HBeAg and ALT and its clinical significance

作　　者：黎莉[1] 贺超奇[1] 刘军[1] 

机构地区：[1]浙江省杭州市萧山区第一人民医院,311200

出　　处：《检验医学与临床》2011年第7期779-780,782,共3页Laboratory Medicine and Clinic

摘　　要：目的研究慢性乙型肝炎(CHB)患者血清乙型肝炎病毒(HBV)DNA含量与HBeAg定量及丙氨酸氨基转移酶(ALT)水平的相关性及其对CHB患者诊断、预后的意义。方法采用实时荧光定量聚合酶链反应(FQ-PCR)、化学发光法(CLIA)及酶法分别测定1 288例CHB患者血清HBV DNA、HBeAg含量及ALT水平。结果 1 288例HBV患者中HBeAg阳性组和阴性组HBV DNA检出率分别为75.3%和24.8%;不同载量HBVDNA组,HBeAg量相差显著,HBV DNA载量高,HBeAg量也高;ALT异常率在HBeAg阳性组的不同HBVDNA载量级中差异无统计学意义(P>0.05),在HBeAg阴性组中随HBV DNA载量级增大而增大,差异有统计学意义(P<0.01)。结论 HBV DNA载量与HBeAg量之间有显著相关性,HBeAg阳性组的HBV DNA阳性率及含量进一步证实了HBeAg确实是反映HBV复制活跃的一个可靠指标,HBeAg阴性时大多病毒复制减弱,但有少数HBV DNA载量为高拷贝时,其肝损伤程度与HBV DNA呈正相关。同时检测HBV DNA、HBeAg量及ALT水平对乙肝患者HBV感染、复制、传染性的判断、治疗方案的选择和疗效判断有一定的指导意义。Objective To study the correlation between serum HBV DNA with e antigen-related quantitation and ALT levels in the patients with chronic hepatitis B（CHB） and its influence on diagnosis and prognosis.Methods The quantitative measurements of serum HBV DNA（with FQ-PCR） and HBeAg（with CLIA） were performed and ELISA was used for ALT detection in 1288 patients with CHB.Results Among the 1288 patients,the detection rates of HBV DNA in HBeAg positive and HBeAg negative patients were 75.3% and 24.8% respectively.The HBeAg quantity was significantly different in different HBV DNA loading groups：higher HBV DNA loading was associated with higher HBeAg quantity.The abnormal rate of ALT in HBeAg（＋） group containing different HBVDNA had no difference in the magnitude（P 〉0.05）,in HBeAg（-） group with HBV DNA contained in the order of the increase（P〈0.01）.Conclusion The high positive rate and contents of HBV DNA in HBeAg positive patients further confirm that HBeAg is a reliable indicator for active HBV replication.The level of hepatocellular damage of HBV with HBeAg positive patients in serum is not correlated to the activity of virus reproduction,but the level of hepatocellular damage of HB with HBeAg negative patients is positively correlated to the load quantity of HBV.Combined detection of HBV DNA,ALT and HBeAg could be clinically most desirable.

关 键 词：慢性乙型肝炎 DNA 病毒 乙型肝炎病毒 乙型肝炎病毒E抗原 丙氨酸氨基转移酶 

分 类 号：R512.62[医药卫生—内科学]