【摘要】 目的　研究慢性乙型肝炎急性发作与血清HBVDNA含量的关系。方法　采用荧光标记(AmpliSensor)定量方法,测定一组自发性反复发作的慢性乙型肝炎患者发作前、中和后的血清HBVDNA含量的变化。结果　①11例患者中有9例(82%)血清HBVDNA含量的高峰值是在最大肝损害之前出现或与丙氨酸转氨酶(ALT)同时达到高峰。而其余2例的高峰值则出现在恢复期;②测定2例数次发作的慢性乙型肝炎患者的系列血清中HBVDNA,也显示了上述特点。并表现出急性肝损害与正常肝功能交替出现的特征。而另1例肝炎肝硬化多次急性发作中,显示持续高水平的病毒血症。结论　血清HBVDNA含量的变化与大部分慢性乙型肝炎的急性发作有着密切的关系,提示乙型肝炎病毒的复制启动和激发了机体的免疫反应,导致了肝细胞的损伤。更多还原

【Abstract】 Objective In this study, we evaluated the relationship between HBV DNA serum level and acute hepatic exacerbation of the disease in chronic hepatitis B patients.Methods A series of serum samples from 14 patients of acute exacerbation of chronic hepatitis B were analyzed for alteratieus in serum HBV DNA and alanine transaminase (ALT) level before, during, and after episode of an acute exacerbation. The serum HBV DNA concentrations were tested by the quantitative polymerase chain reaction (PCR) using the AmpliSensor assay.Results ①Serum HBV DNA average levle in 11 patients significantly increased from 7.148±2.008(logarithm) at 2～8 weeks before maximum injury of liver to 8.416±2.160 (logarithm), the time that ALT reached its peak, and then, following the declining of ALT level, decreaed to 6.093±1.428 (logarithm). In 9 of 11 cases, the HBV DNA peak value occurred before the ALT peak level or at the same time; ②Two patients who experienced several episodes of acute exacerbation showed that the appearance of acute hepatic injury and the relatively normal liver function occurred alternatively. Whereas, one patient with liver cirrhosis showed persistence of high level viremia in three episodes of acute exacerbation in one year.Conclusion ①This investigation revealed a clear correlation between increasing level of serum HBV DNA and actue exacerbation of patinets with chronic hepatitis B. The findings suggest that host′s immune response which causes acute exacerbation of liver injury in patients with chronic hepatitis B is triggered by the change of viremia and HBV replication; ②Patients with severe chronic active hepatitis and persistent hepatitis B virus repliation are at very high risk of rapid progression to cirrhosis.更多还原