HBV DNA载量和血清学标志物在儿童乙型肝炎防控中的应用价值  

Application value of HBV DNA load and serological markers in the prevention and treatment of children′s hepatitis B

作　　者：肖琛月 孙果 刘禹涵 李梅 XIAO Chenyue;SUN Guo;LIU Yuhan;LI Mei(Department of Clinical Laboratory,Affiliated Wuxi People′s Hospital of Nanjing Medical University,Wuxi 214023,Jiangsu;Department of Clinical Laboratory,Affiliated Wuxi Children′s Hospital of Jiangnan University,Wuxi 214023,Jiangsu;Medical Laboratory Major,Public Health College,Nantong University,Nantong 226019,Jiangsu,China)

机构地区：[1]南京医科大学附属无锡人民医院医学检验科,江苏无锡214023 [2]江南大学附属无锡儿童医院医学检验科,江苏无锡214023 [3]南通大学公共卫生学院,江苏南通226019

出　　处：《临床检验杂志》2024年第12期892-896,共5页Chinese Journal of Clinical Laboratory Science

摘　　要：目的分析无锡地区16岁及以下儿童乙型肝炎病毒(HBV)DNA荧光定量检测结果及血清学标志物的分布特征,为完善儿童HBV防控对策提供依据。方法采用荧光定量PCR检测患儿血清中HBV DNA载量,化学发光法和全自动生化分析仪法分别检测HBV血清学标志物和肝功能指标。采用SPSS 13.0统计软件对数据进行统计分析。结果在86例接受HBV DNA荧光定量检测的患儿中,HBV DNA检出45例,阳性率为52.3%,其中34例为高病毒载量。在HBV DNA阳性患儿中,35例为男童,10例为女童,二者之间HBV阳性率比较差异无统计学意义(χ^(2)=3.688,P=0.055)。不同年龄组HBV DNA阳性率比较差异有统计学意义(χ^(2)=5.540,P=0.019),其中15岁患儿阳性率最高。64例患儿检测了HBV血清学抗原抗体指标,共发现9种抗原抗体组合模式;另有80例患儿检测了肝功能指标,发现其中至少有1项肝功能指标异常者33例。结论荧光定量PCR检测HBV DNA和血清学标志物以及肝功能指标检测互为补充,联合应用可以提高儿童乙型肝炎临床诊断的准确性,为临床判断HBV感染程度和传染性提供有效的参考依据。Objective To analyze the fluorescence quantitative detection results of hepatitis B virus(HBV)DNA and distribution characteristics of serological markers in children aged 16 and below in Wuxi area,and provide evidence for improving the prevention and control measures of HBV in children.Methods The HBV DNA load in the serum of pediatric patients was detected by fluorescence quantitative PCR,and the serological markers and liver function indexes of HBV were detected by the chemiluminescence and automatic biochemical analyzer methods,respectively.The data were analyzed using SPSS 13.0 statistical software.Results Among the 86 children who underwent fluorescence quantitative detection of HBV DNA,45 were detected for HBV DNA,with a positive rate of 52.3%,of which 34 had high viral load.Among the children with positive HBV DNA,35 were boys and 10 were girls.There was no statistical significance in the positive rate of HBV DNA between boys and girls(χ^(2)=3.688,P=0.055).There was a statistically significant difference in the positive rate of HBV DNA among different age groups(χ^(2)=5.540,P=0.019),and the highest positive rate was found in children aged 15.A total of 64 pediatric patients were tested for the serological antigen and antibody markers of HBV,and 9 antigen-antibody combination patterns were found.A total of 80 pediatric patients were tested for liver function indexes,and 33 of them were found to have at least one abnormal index.Conclusion The detection of HBV DNA by fluorescence quantitative PCR complements the detection of serological markers and biochemical indexes,and their combination can improve the accuracy of clinical diagnosis of hepatitis B in children,which may provide effective reference for clinical judgment of the degree and infectivity of HBV infection.

关 键 词：乙型肝炎病毒 儿童 荧光定量PCR 病毒载量 血清学标志物 

分 类 号：R446.61[医药卫生—诊断学]