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目的通过对乙型肝炎病毒血清学标志物(HBsAg、抗-HBs、HBeAg、抗-HBe、抗-HBcIgG)的检测及内标、外标两种聚合酶链反应(PCR)方法检测乙型肝炎病毒载量的比对,更好地了解人体内乙型肝炎病毒携带情况,指导临床诊治。方法对经治疗后丙氨酸氨基转移酶(ALT)/天冬氨酸氨基转移酶(AST)正常、COBAS AMPLICOR 定量 PCR(内标法)检测不到乙肝病毒 DNA(HBV-DNA)、用 Abbott AxSYM 微粒子酶免分析法(MEIA)检测乙型肝炎病毒表面抗原(HBsAg)阳性、表面抗体(抗-HBs)阴性、e 抗原(HBeAg)阳性(HBeAg>4 S/CO)、抗-HBe 阴性、抗-HBcIgG 阳性的42例血清,再用上海复星长征医学科学有限公司提供的 HBV-PCR 外标法荧光定量检测试剂盒,Light Cycler实时荧光定量 PCR 仪检测。结果 42例 ALT/AST 正常,HBeAg 阳性(HBeAg>4 S/CO 以上),HBeAg的平均值42.26 S/CO。COBAS AMPLICOR 定量 PCR(内标法)未检测到 HBV-DNA(<300拷贝/ml)的血清;用 Light Cycler 定量 PCR仪(外标法)检测 HBV-DNA,有7例为阳性,7例 HBV-DNA 的平均含量3.1×10~5拷贝/ml,,阳性率17％。结论乙型肝炎病毒 e 抗原阳性并不说明体内病毒复制一定活跃。经治疗后,病毒复制下降,部分患者 e 抗原仍阳性,e 抗原何时消失有待进一步研究。血清学标志与 HBV 复制状态存在不一致性,兼顾内、外标两种 PCR 方法检测 HBV-DNA 更客观。
Objective To detect hepatitis B virus (HBV) serological markers (HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBcIgG) and internal and external standard polymerase chain reaction Comparison of viral load, a better understanding of human hepatitis B virus carriers, to guide clinical diagnosis and treatment. Methods The alanine aminotransferase (ALT) / aspartate aminotransferase (AST) were normal after treatment, HBV DNA (HBV-DNA) was undetectable by COBAS AMPLICOR quantitative PCR (internal standard method) AxisYM microparticle enzyme immunoassay (MEIA) was used to detect positive for hepatitis B virus surface antigen (HBsAg), negative for surface anti-HBs, positive for e antigen (HBeAg> 4 S / CO) Anti-HBcIgG-positive 42 cases of serum, and then provided by Shanghai Fosun Changzheng Medical Science Co., Ltd. HBV-PCR external standard fluorescence quantitative detection kit, Light Cycler real-time PCR detection. Results 42 patients had normal ALT / AST, HBeAg positive (HBeAg> 4 S / CO or above) and mean HBeAg 42.26 S / CO. Serum of HBV-DNA (<300 copies / ml) was not detected by COBAS AMPLICOR quantitative PCR (internal standard method); HBV-DNA was detected by Light Cycler quantitative PCR (external standard method) The average content of DNA 3.1 × 10 ~ 5 copies / ml, the positive rate of 17%. Conclusion The positive result of hepatitis B virus e antigen does not indicate that the virus replication in vivo must be active. After treatment, virus replication decreased, some patients e antigen is still positive, e antigen disappeared for further study. Serological markers and HBV replication status inconsistencies, both internal and external standard PCR detection of HBV-DNA two more objective.