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目的 :了解启东肝癌高发区抗 - HBc阳性慢性乙肝患者血清中 HBVDNA分布情况。方法 :采用 EL ISA法筛选慢性乙肝患者中抗 - HBc阳性者 ,再用聚合酶链反应 (PCR)检测这些血清中的 HBVDNA。结果 :HBVDNA总检出率为 75 .2 4 % (15 8/2 10 )。抗 - HBc与 HBs Ag、HBe Ag同在时 HBVDNA阳性率最高 ,达 97.2 6 % (71/73) ,显著高于其它模式 (P<0 .0 0 5 )。抗 - HBc/HBs Ag阳性血清中 HBVDNA检出率为 81.0 8% (15 0 /185 ) ,单纯抗 - HBc/HBs Ag阳性血清中 HBVDNA检出率为 80 .77% (42 /5 2 ) ,单纯抗 - HBc阳性血清中检出率为 2 0 % (1/5 )。结论 :抗 - HBc是乙肝病毒感染的一个直接标志。判断患者的传染性应通过免疫学和基因学两种方法来检测。启东慢性乙肝患者中HBVDNA整合现象可能要高于其它地区 ,这或许是启东肝癌高发的机制之一 ,值得进一步研究。基因学和免疫学方法检测乙肝病毒感染情况各有利弊 ,应互补共存。
Objective: To understand the distribution of HBV DNA in the serum of patients with anti-HBc positive chronic hepatitis B in Qidong high incidence area of liver cancer. Methods: EL-ISA was used to screen anti-HBc positive patients in chronic hepatitis B patients. The HBV DNA in these serums was detected by polymerase chain reaction (PCR). Results: The total detection rate of HBV DNA was 75.24% (15 8/2 10 ). The highest HBVDNA positive rate was 97.26% (71/73) when anti-HBc was coexpressed with HBsAg and HBeAg, which was significantly higher than other models (P<0.05). The detection rate of HBVDNA in anti-HBc/HBs Ag positive serum was 81.08% (15 0 /185), and the detection rate of HBV DNA in anti-HBc/HBs Ag positive serum was 80.77% (42 /5 2). The detection rate of pure anti-HBc positive serum was 20% (1/5). Conclusion: Anti-HBc is a direct marker of hepatitis B virus infection. Judging the patient’s infectivity should be detected by both immunological and genetic methods. The HBV DNA integration in patients with chronic hepatitis B in Qidong may be higher than in other regions. This may be one of the mechanisms of the high incidence of liver cancer in Qidong, and it is worth further study. Genetic and immunological methods for the detection of hepatitis B virus infection have advantages and disadvantages and should co-exist with each other.