高灵敏度HBVDNA检测指导慢性乙型肝炎患者抗病毒治疗的临床意义  

The clinical significance of high sensitivity HBV DNA detection for the treatment of antiviral therapy in patients with chronic hepatitis B

作　　者：邵国辉[1] 闫香芹 陈合民[1] 张雷[1] 孙敏[1] 孙瑜[1] 

机构地区：[1]山东省济宁市传染病医院一病区,济宁市272031

出　　处：《中华实验和临床感染病杂志（电子版）》2016年第1期46-48,共3页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：山东省济宁市科技项目编号(No.2013jnnk09)

摘　　要：目的探讨高灵敏度HBV DNA检测对于指导HBV DNA低载量慢性乙型肝炎（CHB）患者抗病毒治疗的临床意义。方法收集应用国产试剂检测结果低于检测下限（〈10~3 IU/ml）的拟停药组112例患者和拟用药组48例患者共160份血清标本采用COBAS Amplicor系统再次进行检测,并与HBs Ag定量结果进行对照分析。结果经国产试剂检测结果低于检测下限（〈10~3 IU/ml）的160份血清经COBAS Amplicor系统再次检测有52例（32.50%）标本HBV DNA〉10~3 IU/ml,高于高灵敏度HBV DNA检测下限（20 IU/ml）的标本共115份（占71.88%）。拟停药组患者HBV DNA≥20 IU/ml者有72例（占64.29%）;拟用药组患者中有19例HBV DNA〉10~3 IU/ml,43例≥20 IU/ml（占89.58%）。应用COBAS试剂检测HBV DNA不同载量组别与HBs Ag浓度对数值均呈显著正相关（P〈0.01）。结论对国产试剂检测HBV DNA低载量患者应进一步做高灵敏的定量PCR试剂检测,可更好地指导患者初始应用或停用核苷（酸）类药物。Objective To investigate the clinical significance of the high sensitive HBV DNA detection for the antiviral treatment of the chronic hepatitis B（CHB） patients with HBV DNA low viral load. Methods Total of 160 sera specimens separated from 112 cases of quasi discontinuation group which were detected lower than the detection line（ 10~3 IU/ml） and 48 cases of quasi treatment group detected by domestic reagent were tested again using COBAS Amplicor system and compared with the results of quantitative HBs Ag. Results There were 52（32.5%） cases with HBV DNA quantitative value 10~3 IU/ml by Amplicor COBAS system out of 160 serum samples lower than the detection line（10~3 IU/ml） detected by domestic reagent, 115（71.88%） samples were detected higher than the high sensitive HBV DNA detection line（20 IU/ml）. And 72（64.29%） cases of the withdrawal group were detected than 20 IU/ml; in the treatment group, 19 cases were detected higher than 10~3 IU/ml, 43（89.58%） cases were detected ≥ 20 IU/ml in quasi treatment group. There was a significant positive correlation between different HBV DNA load groups by COBAS reagent detection and HBs Ag concentration logarithm value（P〈0.01）. Conclusions High sensitive quantitative PCR should be furtherly conducted for HBV DNA low load patients to guide the initial application or discontinuation of nucleos（t）ide drugs.

关 键 词：肝炎病毒 乙型 荧光定量PCR COBAS Amplicor系统 临床应用 

分 类 号：R512.62[医药卫生—内科学]