乙型肝炎表面抗原和表面抗体同时阳性患者随访分析  

Follow-up study on hepatitis B patients with simultaneously positive HBsAg and anti-HBs

作　　者：刘勇[1,2] 周锦勇 潘金顺[1,2] 李雷[3] 顾光煜[3] 

机构地区：[1]南京大学医学院附属鼓楼医院科研部,南京210008 [2]江苏省医学分子技术重点实验室,南京210008 [3]南京大学医学院附属鼓楼医院检验科,南京210008

出　　处：《检验医学与临床》2014年第21期2968-2970,2973,共4页Laboratory Medicine and Clinic

基　　金：江苏省南京市卫生局科研课题(YKK09114)

摘　　要：目的分析乙型肝炎表面抗原(HBsAg)和乙型肝炎表面抗体(抗-HBs)同时阳性的乙型肝炎病毒(HBV)感染者病毒学特征动态变化。方法对53例HBsAg和抗-HBs同时阳性患者进行平均13.5个月的随访,检测随访前后血清HBV标志物,并对HBV DNA进行定量检测及丙氨酸氨基转移酶(ALT)检测,分析其病毒学特征变化特点。结果 53例患者随访期间,4例(7.55%)HBsAg转为阴性,13例(24.53%)抗-HBs转为阴性,而36例(67.92%)HBsAg和抗-HBs仍同时为阳性。随访后患者血清HBsAg与抗-HBs水平、乙型肝炎e抗原(HBeAg)阳性率及ALT水平与随访前相比差异无统计学意义(P>0.05),随访后HBV DNA水平(3.44±1.60log10)IU/mL较随访前(3.00±1.36)log10IU/mL降低,差异有统计学意义(P<0.05)。结论大多数HBsAg与抗-HBs同时阳性的HBV感染者抗原与抗体可长期存在,HBsAg及HBV DNA水平较低、HBeAg阴性患者更易发生HBsAg转阴。Objective To analyze the dynamic change of virological characteristics in hepatitis B patients with coexistence of HBsAg and anti-HBs.Methods 53 patients with coexistence of HBsAg/anti-HBs were followed up for average 13.5months.ALT,HBV serological markers and HBV DNA were detected before and after follow up.Results During follow-up,4cases（7.55%）showed HBsAg negative conversion,13cases（24.53%）presented antiHBs negative conversion and 36cases（67.92%）had still positive HBsAg and anti-HBs.After follow-up,the serum levels of HBsAg,anti-HBs,positive rate of HBeAg as well as ALT had no statistical differences compared with before follow up（P〉0.05）,while the level of HBV DNA was decreased from（3.44±1.60）log10IU/mL to（3.00±1.36）log10IU/mL,the difference had statistical significance（P〈0.05）.Conclusion Most of hepatitis B virus infected individuals with simultaneously positive HBsAg and anti-HBs may have the long term existence of allergen and antibody,the levels of HBsAg and HBV DNA are lower and the patients with negative HBeAg are easy to happen the HBsAg negative conversion.

关 键 词：乙型肝炎病毒 乙型肝炎表面抗原 乙型肝炎表面抗体 病毒学特征 

分 类 号：R512.62[医药卫生—内科学]