【摘要】 目的:探讨乙型肝炎患者的乙型肝炎病毒血清学标志(HBVM)与HBVDNA及HBVDNA前C/C区变异检测结果的相关性与临床意义。方法:对359例乙型肝炎患者血清的HBVM和HBVDNA及HBVDNA前C区1896/1814位变异检测结果进行比较;HBVM用ELISA定性分析法检测;HBVDNA用PCR荧光定量法检测;HBVDNA前C/C区用基因芯片显色法检测。结果:急性乙型肝炎、慢性乙型肝炎、乙型肝炎肝硬化HBVDNA检出率分别为81.8%、62.4%、44.7%,三组进行组间比较,差异均有显著性(P<0.01);HBsAg与HBeAg均阳性组HBVDNA检出率显著高于HBsAg与抗HBe均阳性组(P<0.01);HBsAg与抗HBe均阳性组的变异率高达50.7%,显著高于HBsAg与HBeAg均阳性组(P<0.01)。结论:HBVDNA是评价HBV活动最理想的标志;HBVDNA前C/C区变异在我国乙型肝炎患者中普遍存在,对抗HBe阳性患者的临床意义更大;抗HBe的出现不能作为HBV复制停止的指标;HBVDNA量的变化可作为临床评价病毒复制和抗病毒疗效的参考指标。更多还原

【Abstract】 Objective Serum samples of 359 cases with hepatitis B were detected for hepatitis B virus markers(HBV-M),HBV-DNA and polymorphism of HBV-DNA pre-c/c-region,in order to investigation the relationship among HBV-DNA,HBV M and polymorphism of HBV-DNA pre-c/c-region,and its clinical significant.Methods HBV-M were detected by ELISA.HBV-DNA were detected by PCR.Polymorphism of HBV-DNA pre-c/c-region were detected by HBV gene chip.Results HBV-DNA positive rates about acute,chronic hepatitis B and liver cirrhosis were 81.8%,62.4% and 44.7%.The positive rates of HBV-DNA in the three groups showed significant differences(P<0.01).HBV-DNA positive rate in the HBsAg and HBeAg positive group was higher than that in the HBsAg and anti-HBe positive group(P<0.01).The HBV-DNA of HBsAg and anti-HBe positive group mutation rate was 50.7%,which was higher than that in the HBsAg and HBeAg positive group(P<0.01).Conclusion HBV-DNA can be treated as a sign of HBV activity.The polymorphism of HBV-DNA pre-c/c-region commonly existed in chronic hepatitis B patients of the our country,this study has bigger clinical significance in hepatitis B patients of anti-HBe.The appearance of anti-HBe can not be taken as indicator of ceasing of HBV replication.The changes in HBV-DNA titers may be used as clinical evaluation on HBV replication and index for anti-viral therapeutic effect.更多还原