慢性乙型肝炎患者HBV基因表型与血清学测定的临床意义  

Clinical Significance of HBV Molecular Genotypes and Quantitative Serology Detection in Patients with Chronic Hepatitis B

作　　者：顾利江 卜劲松 陈捷 

机构地区：[1]浙江省绍兴市上虞人民医院检验科,312300

出　　处：《医学研究杂志》2015年第5期160-162,共3页Journal of Medical Research

摘　　要：目的分析慢性乙型肝炎患者HBV基因表型和血清学特征,以探讨二者的临床意义。方法检测210例慢性乙型肝炎患者HBV DNA载量和HBV基因亚型、HBV血清标志物HBs Ag和HBe Ag以及ALT水平,分析免疫耐受期、免疫清除期、低水平复制期和复发期4个时相中HBV基因亚型与血清标志物水平、HBs Ag效价与HBV DNA载量、HBe Ag及ALT水平的相关性。结果慢性乙型肝炎患者HBV基因型主要为HBV DNA高载量的B2和中等载量的C2亚型,阳性率分别为59.0%和25.2%。B2亚型与HBs Ag、HBe Ag和ALT水平均呈显著正相关(P<0.01),C2亚型与各指标水平均无显著相关性(P<0.05)。乙型肝炎不同时相的基因亚型阳性率之间差异无统计学意义(P>0.05),但HBs Ag水平与HBV DNA量、HBe Ag和ALT水平分别存在不同的相关性。结论 HBV基因分型和血清学检测可早期预测慢性乙型肝炎患者长期疾病进展结果。Objective To characterize the molecular genotypes and quantitative serological biomarker, and to explore their clinical significance in patients with chronic hepatitis B （CHB）. Methods A total of 210 CHB patients were enrolled and HBV DNA loading, HBV molecular genotypes, quantitative serological biomarker, and ALT were measured. Patients were grouped according to the natural phases of HBV infection： HBeAg （ ＋ ） immune tolerance, immune clearance, HBeAg （ - ） low replicative and reactivation phase. The correlation was analyzed between molecular genotypes and serological biomarkers, HBsAg and other biomarkers. Results Subgenotypes B2 with high level of HBV DNA and C2 with middle level of HBV DNA were found to he most prevalent. The positive rates were 59.0% （B2） and 25.2% （C2）. Patients genotype with B showing more potent viral activity. Subgenotype B2 was sinificantly corelated with HB- sag, HbeAg, and ALT levels（P 〈 0.01 ）, but there was no statistical difference for subgenotype C2. There was statistical difference be- tween positive rates of subgenotypes（P 〉 0.05） , but HBsAg level was found to be significantly correlated with HBV DNA, HBeAg, ALT levels during some phases of CHB. Conclusion Molecular genotyping and quantitative serological biomarkers detection might be helpful for earlier prediction of the long - term disease outcomes in patients with CHB.

关 键 词：慢性乙型肝炎 HBV基因型 定量血清学检测 疾病结果 

分 类 号：R575[医药卫生—消化系统]