乙型肝炎病毒总DNA、共价闭合环状DNA和HBsAg在各种慢性乙型肝炎病毒感染者中的定量检测  

Quantitation of hepatitis B virus total DNA, covalently closed circular DNA and HBsAg in patients with different stages of hepatitis B virus infection

作　　者：李莹[1] 韩涛[1] 高英堂[1] 杜智[1] 王毅军[1] 景丽[1] 刘彤[1] 郭华[1] 马晓艳[1] 裴彦祯[1] 

机构地区：[1]天津市第三中心医院,天津市人工细胞重点实验室,300170

出　　处：《中华传染病杂志》2012年第8期463-467,共5页Chinese Journal of Infectious Diseases

基　　金：国家重点基础研究发展计划（973计划）资助项目（2007CB512801）;天津市卫生局重点攻关资助项目（07KG9）;“十一五”国家科技重大专项资助项目（2008ZX10002-005）

摘　　要：目的定量检测慢性乙型肝炎（CHB）、乙型肝炎肝硬化（LC）、肝细胞癌（HCC）患者HBV总DNA（tDNA）、HBV共价闭合环状DNA（cccDNA）和HBsAg，并探讨其特点。方法荧光定量PCR检测21例CHB、23例LC和25例HCC患者外周血和肝组织标本HBVtDNA、HBVcccDNA，化学发光法定量检测外周血HBsAg。正态数据采用ANOVA分析和t检验，相关性分析采用Pearson检验，非正态数据采用秩和检验。结果在CHB、LC和HCC患者中，外周血HBVtDNA分别为（5．38±2．08）、（4．96±1．65）和（4．18±0．91）lg拷贝／mL，肝组织HBVtDNA分别为（7．18±1．91）、（6．51±1．87）和（5．87±1．47）lg拷贝／μg，肝组织HBVcccDNA分别为（3．53±2．03）、（2．63±2．13）和（0．58±1．40）lg拷贝／μg，外周血HBsAg分别为（3．30±0．65）、（3．12±0．52）和（2．60±1．03）1g IU／mL，CHB与HCC患者比较，差异均有统计学意义（t=2．446，P=0．013；t=2．562，P=0．014；t=5．799，P〈0．01；t=2．709，P=0．003），LC与HCC患者肝组织HBVcccDNA及HBsAg定量比较，差异有统计学意义（t=3．894，P〈0．01；t=2．237，P=0．023）。外周血均未检出HBVcccDNA。HBsAg定量与外周血HBVtDNA（r=0．290，P=0．016）、肝组织HBVtDNA（r=0．372，P=0．002）及肝组织HBVceeDNA（r=0．378，P=0．001）均有关。结论HBVtDNA、HBVcccDNA、HBsAg在CHB、LC、HCC患者呈逐渐降低趋势，HBsAg定量与外周血HBVtDNA、肝组织HBVtDNA及肝组织HBVCCCDNA有关。Objective To quantitatively analyze total hepatitis B virus （HBV） DNA （HBV tDNA）, covalently closed circular DNA （cccDNA） and HBsAg in paatients with chronic hepatitis B （CHB）, HBV-related liver cirrhosis （LC） and hepatocellular carcinoma （HCC）, and to analyze the characteristics. Methods HBV tDNA and HBV ceeDNA in the serum and liver biopsy samples were measured in 21 CHB, 23 LC and 25 HCC patients by real time polymerase chain reaction （PCR） assay. HBsAg titer was measured by chemiluminescence. Normally distributed variables among multiple groups were analyzed by ANOVA and t-test. Correlation between two variables was tested using Pearson correlation analysis. Skewed distribution was tested using Rank sum test. Results In CHB, LCand HCCpatients, the serum HBVtDNAlevels were （5.38±2.08）, （4.96±1.65） and （4. 18±0. 91） lg copy/mL, respectively; the intrahepatic HBV tDNA levels in three groups were （7.18±1.91）, （6. 51±1.87） and （5.87±1.47） lg copyg, respectively3 the intrahepatic HBV cccDNA levels were （3.53±2.03）, （2.63..2.13） and （0.58±1.40） lg copyllg, respectively; the serum HBsAg levels were （3.30±0.65）, （3.12±0.52） and （2.60±1.03） lg IU/mL, respectively. In CHB patients, the serum HBV tDNA, intrahepatic HBV tDNA, HBV cccDNA and HBsAg levels were all significantly higher than those of HCC patients （t=2. 446, P=0. 013; t=2. 562, P=0. 0143 t=5. 799, P〈0. 013 t=2. 709, P=0. 003, respectively）. However, only intrahepatic HBV cccDNA and HBsAg levels were statistically different between LC and HCC patients （t= -3. 894, P〈0. 013 t=--2. 237, P=0. 023, respectively）. HBV cccDNA was all negative in the serum of 69 patients. The serum HBsAg level, was positivety correlated with serum HBV tDNA （r=0. 290, P=0. 016）, intrahepatic HBV tDNA （r= 0. 372, P= 0. 002） and intrahepatic HBV cccDNA （r= 0. 378, P= 0. 001）. Conclusions The levels of HBV tDNA, HBV ceeDNA and HBsAg decrease gradually with the disease progression

关 键 词：肝炎 乙型 慢性 肝炎病毒 乙型 癌 肝细胞 病毒复制 DNA 病毒 

分 类 号：R51[医药卫生—内科学]