【摘要】 目的分析比较HBV血清标志物HBe Ag与抗-HBe同时阳性、同时阴性及单独阳性患者的病毒复制情况。方法采用电化学发光法检测HBV血清标志物,从中筛选出HBe Ag与抗-HBe同时阳性或均为阴性以及HBe Ag单独阳性或抗-HBe单独阳性的标本,检测该类标本HBV DNA定量值。计数资料组间比较采用χ2检验。结果检测447例患者HBV血清标志物,所有患者HBs Ag均为阳性。HBe Ag与抗-HBe同时阳性患者32例,阳性率为7.16%,其中HBV DNA<5×102拷贝/ml占84.38%,5×102拷贝/ml<HBV DNA<1×104拷贝/ml占12.50%,1×104拷贝/ml<HBV DNA<1×107拷贝/ml占3.13%;HBe Ag与抗-HBe同时阳性组的HBV DNA含量分布低于HBe Ag单独阳性组,差异有统计学意义(χ2=13.21,P<0.01);抗-HBe阳性组的HBV DNA含量分布低于抗-HBe阴性组(χ2=74.12,P<0.01);HBe Ag阴性的患者218例,HBV DNA>1×104拷贝/ml共9例(4.13%)。结论HBe Ag与抗-HBe同时阳性过去认为是不常见模式,但临床上并不少见,且病毒复制处于较高水平的仍占一定比例;当抗-HBe出现后,病毒复制减弱。血清HBe Ag阴性情况下,部分患者病毒仍存在较高水平复制。因此,HBe Ag存在与否不能作为抗病毒、疗效评价、传染性强弱的依据。更多还原

【Abstract】 Objective To analyze and compare the viral replication in patients with hepatitis B virus( HBV) when serum markers HBe Ag and HBe Ab are both positive,or HBe Ag alone is positive,or HBe Ab alone is positive,or both are negative. Methods Electrochemiluminescence method was used to detect serum markers of HBV,and the samples with HBe Ag and HBe Ab being both positive,or HBe Ag alone being positive,or HBe Ab alone being positive,or both being negative were screened out,and the HBV DNA quantitative values of the samples were determined. Comparison of categorical data was made by chi- square test. Results Among 447 patients examined for serum markers of HBV,all were positive for HBs Ag. HBe Ag and HBe Ab were simultaneously detected in 32 cases,with a positive rate of 7. 16%. Of the 32 cases,84. 38% had HBV DNA levels of < 5 × 102 copies / ml,12. 50% had HBV DNA levels between 5 × 102 copies / ml and 1 × 104 copies / ml,and3. 13% had HBV DNA levels between 1 × 104 copies / ml and 1 × 107 copies / ml. The HBV DNA level of the HBe Ag / HBe Ab- positive group was significantly lower than that of the HBe Ag- positive group( χ2= 13. 21,P < 0. 01); the HBV DNA level of the HBe Ab- positive group was significantly lower than that of the HBe Ab- negative group( χ2= 74. 12,P < 0. 01). A total of 218 cases had negative HBe Ag,and 9( 4. 13%) of them had HBV DNA levels of >1 ×104copies / ml. Conclusion Being positive for both HBe Ag and HBe Ab is considered to be rare in the past; however,it is commonly seen clinically,and a proportion of patients have a relatively high level of viral replication. The viral replication weakens when HBe Ab appears. In cases of negative serum HBe Ag,some patients still show a high level of viral replication. Therefore,the presence or absence of HBe Ag cannot be regarded as the evidence in the assessment of antiviral efficacy and infectivity.更多还原