高敏HBV-DNA检测在低病毒血症患者抗病毒治疗监测中的应用研究  

Application of high-sensitivity hepatitis B virus-DNA testing in the monitoring of antiviral therapy in patients with low-level viremia

作　　者：龙黎 张卿 熊晏[1] 罗新华[1] 邵和军[1] Long Li;Zhang Qing;Xiong Yan;Luo Xinhua;Shao Hejun(Department of Infectious Diseases of Guizhou Provincial People’s Hospital,Guiyang 550002,Guizhou,China)

机构地区：[1]贵州省人民医院感染科,贵州贵阳550002

出　　处：《贵州医药》2022年第8期1182-1183,1186,共3页Guizhou Medical Journal

摘　　要：目的探讨高敏PCR在慢乙肝低病毒血症患者抗病毒治疗监测中的临床应用价值。方法收集采用普通PCR检测HBV-DNA水平低于检测下限(<200IU/mL)的175例慢性乙型肝炎患者血清标本,采用高敏PCR试剂再次检测其HBV-DNA水平(检测下限<10IU/mL),并将HBV-DNA水平与HBeAg定量、肝硬度值结果进行对照分析。结果175份经普通PCR检测HBV-DNA水平低于检测下限(<200IU/mL)的标本再次采用高敏PCR检测后存在以下状况:>200、100-200、10-100、<10IU/mL和阴性,占比分别为8.5%、9.7%、28%、14.9%和38.9%。HBV-DNA水平降低同时HBeAg定量水平也逐渐降低。其中,HBV-DNA阴性组HBeAg定量水平显著低于100-200IU/mL组和>200IU/mL组(P<0.05)。HBV-DNA>200IU/mL组肝硬度值与HBV-DNA阴性组肝硬度值,差异有统计学意义(P=0.023),其余各组之间比较,差异无统计学意义(P均>0.05)。结论高敏PCR检测技术更能准确反应感染者的乙肝病毒复制水平;血清HBeAg定量及肝硬度结果也显示了其与HBV-DNA水平的一致性,能更好的对低病毒血症患者进行抗病毒治疗监测。Objective To investigate the clinical application value of high-sensitivity polymerase chain reaction(PCR)in the monitoring of antiviral therapy in patients with chronic hepatitis B complicated with low-level viremia.Methods Enrolled serum specimens from 175 patients with chronic hepatitis B whose hepatitis B virus(HBV)-DNA levels,which were detected by common PCR,were below the lower limit of detection(<200 IU/mL).The HBV-DNA levels(lower limit of detection<10 IU/mL)of patients were detected again using high-sensitivity PCR reagents,followed by the further comparison of HBV-DNA levels with the results of hepatitis B e antigen(HBeAg)quantification and liver stiffness values.Results The results of high-sensitivity PCR on serum samples from 175 patients with HBV-DNA levels below the lower limit of common PCR detection(<200 IU/mL)showed 8.5%,9.7%,28%,14.9%,and 38.9%of patients with HBV-DNA levels of>200 IU/mL,100-200 IU/mL,10-100 IU/mL,and<10 IU/mL,and negative patients,respectively.In addition,the serum HBV-DNA level and the quantitative level of serum HBeAg were gradually reduced.Moreover,the serum HBeAg quantification level in the HBV-DNA negative group was significantly lower than that in the 100-200 IU/mL and>200 IU/mL groups(P<0.05).There were obvious statistical significantly differences in the liver stiffness values between the HBV-DNA>200 IU/mL group and the HBV-DNA negative group(P=0.023),and the remaining groups there were no statistical significantly differences(all P>0.05).Conclusion The high-sensitivity PCR assay technique more accurately reflects the level of HBV replication in infected patients,and the results of serum HBeAg quantification and liver stiffness also exhibit consistency with HBV-DNA levels,providing better monitoring of antiviral therapy in patients with low-level viremia.

关 键 词：慢性乙型病毒性肝炎 HBV-DNA 高敏PCR 

分 类 号：R446[医药卫生—诊断学] R511[医药卫生—临床医学]