目的探讨肝硬化患者血清标志物模式(HBV-M)与病毒复制指标HBV-DNA相关性及意义,为临床治疗肝硬化提供依据。方法分别利用化学发光法和荧光定量PCR法对138例肝硬化患者血清进行HBVM和HBV-DNA定量测定。结果 138例肝硬化患者中HBV-M感染模式有9种,HBe Ag阴性者检出率为69.5%,高于HBe Ag阳性者;HBe Ag阴性组和HBe Ag阳性组HBV-DNA阳性率分别为62.5%、71.5%,HBe Ag阴性组HBV-DNA含量103~104IU·m L-1构成比为43.8%(42/96),105~107IU·m L-1构成比为18.7%(18/96);HBe Ag阳性组HBV-DNA含量103~104IU·m L-1构成比为21.4%(9/42),105~107IU·m L-1构成比为50.1%(21/42)。结论乙型肝炎肝硬化患者以HBe Ag阴性及HBV-DNA阳性居多,临床应高度重视,早期应进行积极有效的HBV抗病毒治疗。
Objective To explore the relationship between hepatitis B virus markers (HBVM) and HBV - DNA quantification in order to provide evidence for clinical therapy of liver cirrhosis. Methods HBVM for138 samples obtained from routine work in clini- cal laboratory were investigated by time - resolution immunofluorescence. HBV - DNA quantity of those samples were detected with the real time fluorescent quantitative PCR instrument. Results 138 samples tested were divided into 11 models. The infection patterns con- taining negative HBeAg were the most,which accounted for 69.5%. The positive rates of HBV - DNA in negative and positive HBeAg patients were 62.5 % and 71.5 %, respectively. In samples with different levels of HBV - DNA, constituent ratios in serum had significant difference (P 〈 0.05 ). The percentage of the positive cases ( HBV - DNA = 103 ~ 104 copies ~ mL-l ) was 43.8 % (42/96) in HBeAg negative group and 21.4% (9/42) in HBeAg positive group. However,the percentage of the positive cases ( HBV - DNA = 105 ~ l0T copies ~ mL-1 ) was 18.7% (18/96) in HBeAg negative group and 50.1% (21/42) in HBeAg positive group. Conclusion The liver cirrhosis is closely related to HBV infection in which negative HBeAg was predominant. Reflection of HBV - DNA in liver cirrhosis pa- tient blood can reflect the degree of HBV duplication and activeness in those patients,which have an important value on clinical judge- ment of liver cirrhosis degree and guiding anticirrhosis.