抗-HBs阳性不同血清学模式病毒学及临床意义分析  

Analysis of Viremia and Clinical Significance in Different Serological Patterns of HBV Infection Associated with Anti-HBs

作　　者：黄利华[1] 黄祖瑚[1] 蒋耀明[1] 刘海肃[1] 

机构地区：[1]无锡市传染病医院,无锡214007

出　　处：《临床消化病杂志》2001年第4期173-175,共3页Chinese Journal of Clinical Gastroenterology

摘　　要：目的 :通过对抗 - HBs阳性不同血清学模式病毒学和临床意义的分析 ,了解抗 - HBs阳性不同血清学模式的特点 ,探讨其形成机理及抗 - HBs的作用。方法 :采用 Abbott和 PCR定量、PCR定性方法分别检测抗 - HBs阳性不同血清学模式病人的 HBV血清标志物和 HBV DNA。结果 :抗 - HBs、抗 - HBe、抗 - HBc阳性组与其它模式组比较 ,其抗 - HBs值显著升高 (P<0 .0 5 ) ;HBs Ag、抗 - HBs、HBe Ag阳性组与其它模式组比较 ,其 HBV DNA含量显著增高 (P<0 .0 1) ;定性检测 HBV DNA阳性组与 HBV DNA阴性组比较抗 - HBs值 ,前者抗 - HBs值显著降低 (P<0 .0 5 ) ;抗 - HBs阳性不同血清学模式病人生化指标比较无显著性差异 (P>0 .0 5 ) ;抗 - HBs阳性不同血清学模式病人比较其肝炎临床类型的构成有非常显著性差异 (P<0 .0 0 5 ) :即抗 - HBs、抗 - HBe、抗 - HBc阳性组主要表现为急性肝炎 ,HBs Ag、抗 - HBs、HBe Ag阳性组与HBs Ag、抗 - HBs阳性组主要表现为慢性肝炎。结论 :抗 - HBs阳性时 HBV处于复制水平 ,但并不标志 HBV复制的停止 ,仅预示病人感染相和恢复相的动态消长过程。如抗 - HBs水平不断提高 ,则感染相向稳定的恢复相发展。同时从肝功能损伤的程度及肝炎临床类型分析 ,提示抗 -Purpose: To study the character and pathogensis of different serological patterns associated with anti HBs and to evaluate the role of anti HBs by means of analysis of viremia and clinical significance in different serological patterns of HBV infection associated with anti HBs. Methods: Serological markers of hepatitis B virus were detected by Abbott and quantitative and qualitative analysis of HBV DNA were taked by polymerase chain reaction in patients with anti HBs. Results: Anti HBs was significantly high in anti HBs anti HBe anti HBc positive group(P<0.005), while HBV DNA was the highest in HBsAg anti HBs HBeAg positive group(P<0.01). Anti HBs was higher in HBV DNA positive group than in HBV DNA negative group (P<0.05). Liver function test found there were no difference in different serological patterns of HBV infection associated with anti HBs. Clinical type of hepatitis showed that acute hepatitis was predominant in anti HBs anti HBe anti HBc positive group and chronic hepatitis were dominant in HBsAg anti HBs HBeAg positive group as well as HBsAg anti HBs positive group. Conclusion: The results suggested that anti HBs can decerase virus replication, although existent anti HBs cann't mean that virus replication was over and it indicate the development couse from infection to convalescence. If anti HBs is increasing patients can develop from infection to convalescence. Injury of live and clinical types of hepatitis suggested that anti HBs cause immunity reaction and lead some patients change from active hepatitis to full recorvery at last.

关 键 词：乙型肝炎病毒血清标志物 乙型肝炎病毒脱氧核糖核苷酸 抗-HBs阳性不同血清学模式 

分 类 号：R446.6[医药卫生—诊断学]