54例慢性乙型肝炎患者肝组织乙型肝炎病毒共价闭合环状DNA与血清HBsAg定量检测结果分析  

Quantitative analyses of intrahepatic HBV cccDNA and serum HBsAg in 54 patients with chronic hepatitis B

作　　者：李韦杰[1] 李伯安[2] 赵景民[3] 韩佳琪[1] 刘妍[1] 江玲[1] 毛远丽[2] 鲁凤民[4] 徐东平[1] 

机构地区：[1]解放军第三0二医院肝衰竭诊疗研究中心,北京100039 [2]解放军第三0二医院临床检验中心,北京100039 [3]解放军第三0二医院肝病理科,北京100039 [4]北京大学医学部微生物学系

出　　处：《中华肝脏病杂志》2011年第11期815-817,共3页Chinese Journal of Hepatology

基　　金：军队医院“十二五”临床高新技术项目（2010gxjs009）;国家自然科学基金面上项目（81171617）

摘　　要：目的检测慢性乙型肝炎患者肝组织HBV共价闭合环状DNA（cccDNA）和血清HBsAg，分析两种定量指标之间及其与血清HBVDNA载量的相关性。方法应用PSAD消化＋滚环扩增＋跨缺口实时荧光PCR方法，定量检测54例慢性乙型肝炎患者甲醛固定石蜡包埋肝组织HBVcccDNA水平；用化学发光试剂定量检测患者血清HBsAg。用Pearson检验及直线回归分析方法对数据进行分析。结果患者肝组织HBVcccDNA与血清HBsAg定量水平之间呈正相关（r=0．459，P〈0．01），但与血清HBVDNA载量相关性无统计学意义；血清HBsAg定量水平与血清HBVDNA载量呈正相关（r=0．328，P〈0．05），与病毒复制效率呈负相关（r=－0．373，P〈0．05）。结论慢性乙型肝炎患者肝组织HBVcccDNA载量与血清HBsAg定量水平相关，结合血清HBVDNA定量检测，可以更全面的反映HBV的复制水平，评价抗病毒疗效。Objective To quantitatively detect intrahepatic HBV covalently closed circular DNA （cccDNA） and serum HBsAg; and to analyze the relationship between the two parameters and with serum HBV DNA level. Methods Intrahepatic cccDNA （copies/cell） was quantitated by plasmid-safe ATP- dependent Danes （PSAD） digestion in combination with rolling circle amplification and gap-spanning selective real-time PCR assay using formalin fixed paraffin-embedded liver biopsy samples. HBsAg was measured by chemiluminescence＇s reagent manufactured by Abbott Company using sera sampled at time-point of liver biopsy. Results Intrahepatic cccDNA level was positively correlated with serum HBsAg level （r = 0.459, P 〈 0.001）, but not correlated with serum HBV DNA level. Serum HBsAg level was positively correlated with serum HBV DNA level （r = 0.328, P = 0.015）, and reversely correlated with HBV replicative efficiency defined as the ratio of serum HBV DNA to cccDNA （r = -0.373, P = 0.005）. Conclusion In patients with chronic hepatitis B, intrahepatic cccDNA level is correlated with serum HBsAg level. The two parameters combined with serum HBV DNA may comprehensively reflect HBV replication activity and help evaluation of antiviral therapeutic efficacy.

关 键 词：肝炎病毒  乙型 共价闭合环状DNA 肝炎抗原 乙型 

分 类 号：R51[医药卫生—内科学]