HBeAg阴性慢性乙型肝炎患者血清HBV DNA及HBsAg和HBV cccDNA相关性研究  

Correlations between serum HBV DNA,HBsAg and HBV covalently closed circular DNA(cccDNA)in patients with HBeAg-negative chronic HBV infection

作　　者：张岱[1] 陈明心[1] 王念跃[2] 任伟宏[1] 李延卿[1] ZHANG Dai CHEN Ming-xin WANG Nian-yue REN Wei-hong LI Yan-qing(Department of Clinical Laboratory, the First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan 450000, Chin)

机构地区：[1]河南中医药大学第一附属医院检验科,河南郑州450000 [2]东南大学附属南京第二医院检验科,江苏南京210003

出　　处：《中国病毒病杂志》2016年第4期270-274,共5页Chinese Journal of Viral Diseases

基　　金：河南省基础与前沿技术研究计划项目(112300410031)

摘　　要：目的分析乙型肝炎(乙肝)病毒e抗原(HBeAg)阴性慢性乙型肝炎(chronic hepatitis B,CHB)患者血清乙肝病毒DNA(HBV DNA)、乙肝病毒表面抗原(HBsAg)和乙肝病毒cccDNA的相关性,探讨CHB患者肝细胞内外与活动性肝炎有关的病毒学转变过程。方法对南京第二医院64例未经治疗的HBeAg阴性的CHB患者均进行了肝穿刺获取肝组织样本。按照丙氨酸氨基转移酶>80U/L,HBV DNA>100 000拷贝/ml诊断为活动性肝炎,否则为非活动性肝炎的标准分为两组。化学发光法检测血清HBsAg,Taqman实时PCR法定量检测血清及肝组织中HBV DNA含量,同时检测肝组织中cccDNA。结果血清HBV DNA和血清cccDNA明显相关(r=0.483,P<0.01),和lg肝细胞内总cccDNA明显相关(r=0.723,P<0.01)。血清HBsAg和cccDNA及lg肝细胞内HBV DNA均没有明显的相关性。活动性HBeAg阴性的CHB患者的lg cccDNA及lg肝细胞内总HBV DNA,明显高于非活动性HBeAg阴性的CHB患者。活动性HBeAg阴性的CHB患者,乙肝病毒的复制效率(血清HBV DNA和cccDNA的比率)高出非活动性CHB患者20%以上。血清HBsAg水平及HBsAg与cccDNA的比率在两组患者间差异均无统计学意义。结论 HBeAg阴性的CHB患者,血清HBV DNA水平和cccDNA有明显的相关性,血清HBV DNA可以作为肝细胞内cccDNA含量的替代指标,代表着更高效的HBV复制效率。Objective To assess the correlations between serum HBV DNA,HBsAg and cccDNA in patients with HBsAg-negative chronic HBV infection and explore the HBV dynamic alterations inter-or intra-hepatocytes. Methods Liver punctures were performed for all included 64 patients with HBeAg-negative chronic HBV infection in the study,and the liver tissues were used for further analyses.The patients were diagnosed with active hepatitis,whose serum ALT levels were above 40U/L and serum HBV DNA were above 100 000copies/ml.According to the criterion,all included chronic HBV hepatitis patients were divided into active group and non-active group.HBV DNA were tested in inter-or intra-hepatocytes using Taqman real time florescence quantitative PCR,HBV cccDNA,and serum HBsAg were measured using chemoluminescence. Results Serum HBV DNA and serum cccDNA showed high correlation（r=0.483,P〈0.01）,and the correlation between serum HBV DNA and log inter-hepatocyte was significant（r=0.723,P〈0.01）.There were no significant correlations between serum HBsAg and serum cccDNA and log inter-hepatocyte.The HBV cccDNA and HBV DNA in patients with active HBeAg-negative chronic hepatitis B were significantly higher than that of non-active group.The replication efficiency（ratio of serum HBV DNA and cccDNA）of HBV DNA was20% higher in active group than that in non-active group.The level of serum HBsAg and the ratio of serum HBsAg concentration and serum cccDNA level showed no significant differences between active group and nonactive group. Conclusions In patients with HBeAg-negative chronic hepatitis B,serum HBV DNA significant correlated with cccDNA;however,there was no significant correlation between serum HBsAg and cccDNA.Serum HBV DNA could be an indicator for higher replication efficacy and an alternative for inter-hepatocyte HBV cccDNA.

关 键 词：HBV DNA CCCDNA 乙型肝炎病毒表面抗原 肝穿刺 

分 类 号：R512.62[医药卫生—内科学]