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目的 探讨乙型肝炎病毒 (HBV)感染者不同血清学标志物模式与HBVDNA定量的关系 ,为乙型肝炎的诊断、治疗及预防提供诊据。方法 对 814例血清标本采用酶联免疫吸附试验 (ELISA)检测HBV血清标志物 ,应用实时荧光定量聚合酶链反应 (FQ -PCR)方法检测HBVDNA含量。结果 HBsAg(+ )、HBeAg(+ )、HBcAb(+ )模式HBVDNA阳性率为 87 2 8% (30 2 /346 ) ,HBV拷贝数≥ 10 8/ml占 6 3 87% ;在HBsAg阳性、HBcAb阳性模式中 ,有 4 0例 (48 78% ) ,检测出HBV -DNA ,部分血清标本的HBV -DNA拷贝数较高 ,此可能是HBV前核心区基因突变 ,导致HBeAg不能表达 ,但病毒本身复制未受影响HBeAg(+ )模式的HBVDNA阳性率、拷贝数明显高于其它不同血清学标志物模式 (P <0 0 0 5 )。结论 单凭血清学标志物模式难以准确判断HBV的复制程度及传染性的强弱 ,定量检测HBVDNA能真实反映HBV复制情况 ,对乙型肝炎的诊断及防治提供客观依据。
Objective To investigate the relationship between different serological marker patterns and HBV DNA quantification in patients with hepatitis B virus infection and provide evidence for the diagnosis, treatment and prevention of hepatitis B infection. Methods HBV serum markers were detected by ELISA in 814 serum samples. The content of HBVDNA was detected by real-time fluorescence quantitative polymerase chain reaction (FQ-PCR). Results The positive rates of HBVDNA in HBsAg (+), HBeAg (+) and HBcAb (+) patterns were 87 2 8% (30 2/346) and HBV copies ≥ 10 8 / ml in 6 3 87% In the positive model, there were 40 (48.78%) HBV-DNA detected and some of the serum samples had higher HBV-DNA copy number. This may be due to the HBV pre-core gene mutation, which leads to the failure of HBeAg expression, but the virus itself HBVDNA positive rate of copy unaffected HBeAg (+) mode, the copy number was significantly higher than other different serological marker model (P <0 0 0 5). Conclusion It is difficult to accurately determine the degree of HBV replication and the infectivity of HBV by serological marker model. Quantitative detection of HBVDNA can truly reflect HBV replication and provide an objective basis for the diagnosis and prevention of hepatitis B.