HBeAg和HBeAb共同阳性CHB患者血清HBV RNA表达水平及检测意义  

Serum expression levels of HBV RNA and detection significance in CHB patients with HBeAg and HBeAb co-positive

作　　者：刘潘婷 向瑜[1] 周红菊 陈瀑[1] LIU Panting;XIANG Yu;ZHOU Hongju;CHEN Pu(Department of Clinical Laboratory,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院检验科,重庆400016

出　　处：《检验医学与临床》2022年第21期2885-2889,共5页Laboratory Medicine and Clinic

摘　　要：目的分析乙型肝炎病毒(HBV)e抗原(HBeAg)和HBV e抗体(HBeAb)共同阳性慢性乙型肝炎(CHB)患者血清HBV RNA表达水平,探讨HBV RNA在特殊血清学模式中的检测价值。方法选取2018年5月至2020年12月在重庆医科大学附属第一医院门诊及住院进行治疗的且HBV血清学标志物检测中HBV表面抗原(HBsAg)、HBeAg、HBeAb、HBV核心抗体(HBcAb)均为阳性的CHB患者108例(A组)作为研究对象。另选取同期在该院进行治疗的HBV血清学标志物检测中HBeAg阳性、HBeAb阴性的CHB患者45例(B组)和HBeAg阴性、HBeAb阳性的CHB患者33例(C组)作为对照,采用PCR-荧光探针法检测HBV RNA和HBV DNA的表达水平和基因分型,同时分析HBV RNA与HBV DNA、HBsAg、HBeAg、丙氨酸氨基转移酶(ALT)和天门冬氨酸氨基转移酶(AST)之间的相关性。结果A组B、C基因型血清HBV RNA及HBV DNA水平比较差异无统计学意义(P>0.05)。A组血清HBV RNA与HBV DNA、HBsAg、ALT、AST呈正相关(r=0.723,P<0.001;r=0.270,P=0.005;r=0.479,P<0.001;r=0.395,P<0.001),与HBeAg无相关(r=0.111,P=0.253)。3组中HBV RNA与HBV DNA呈正相关(P<0.05)。3组血清HBV RNA、HBV DNA、HBsAg、HBeAg、ALT、AST水平比较差异有统计学意义(P<0.05)。A组血清HBV RNA、HBV DNA、HBsAg、HBeAg、ALT、AST水平均明显高于C组,差异有统计学意义(P<0.017);A组血清HBsAg、AST水平均高于B组,A组血清HBeAg水平低于B组,差异有统计学意义(P<0.017)。结论HBeAg和HBeAb共同阳性CHB患者血清HBV RNA与HBV DNA具有良好的相关性,血清HBV RNA检测具有潜在的临床价值,且HBeAg和HBeAb共同阳性的CHB患者体内HBV复制活跃,肝功能损伤较严重,临床应重视此类患者的诊疗。Objective To analyze the serum expression levels of hepatitis B virus(HBV)RNA in chronic hepatitis B(CHB)patients with HBV e antigen(HBeAg)and HBV e antibody(HBeAb)co-positive,and to explore the value of HBV RNA detection in special serological pattern.Methods A total of 108 CHB patients(group A)who were treated in the first Affiliated Hospital of Chongqing Medical University from May 2018 to December 2020 and were positive for HBV surface antigen(HBsAg),HBeAg,HBeAb and hepatitis B core antibody(HBcAb)were selected as subjects.During the same period,45 HBeAg-positive and HBeAb-negative CHB patients(group B)and 33 HBeAg-negative and HBeAb-positive CHB patients(group C)were selected in this hospital as controls.The expression levels and genotypes of HBV RNA and HBV DNA were detected by PCR-fluorescence probe method.The correlations between HBV RNA and HBV DNA,HBsAg,HBeAg,alanine aminotransferase(ALT)and aspartate aminotransferase(AST)were analyzed.Results There was no significant difference in serum HBV RNA and HBV DNA levels of B and C genotypes in group A(P>0.05).Serum HBV RNA of group A was positively correlated with HBV DNA,HBsAg,ALT,AST(r=0.723,P<0.001;r=0.270,P=0.005;r=0.479,P<0.001;r=0.395,P<0.001),no correlation with HBeAg(r=0.111,P=0.253).HBV RNA was positively correlated with HBV DNA in the three groups(P<0.05).There were significant differences in serum HBV RNA,HBV DNA,HBsAg,HBeAg,ALT and AST among the three groups(P<0.05).The serum levels of HBV RNA,HBV DNA,HBsAg,HBeAg,ALT,AST in group A were significantly higher than those in group C,the differences were statistically significant(P<0.017).Serum HBsAg and AST levels in group A were higher than those in group B,and serum HBeAg level in group A was lower than that in group B,the differences were statistically significant(P<0.017).Conclusion The serum HBV RNA of HBeAg and HBeAb co-positive CHB patients has a good correlation with HBV DNA,and the detection of serum HBV RNA has potential clinical value;CHB patients with HBeAg and HBeAb co-positive have activ

关 键 词：乙型肝炎病毒 慢性乙型肝炎 血清学标志物 

分 类 号：R512.62[医药卫生—内科学]