低浓度hbsag人群hbv dna与hbv m定量结果的关系及评价

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1、低浓度HBsAg人群HBVDNA与HBVM定量结果的关系及评价作者：成军孙长贵,陈瑜,许志良,戴玉柱,孙关忠,李晓军【摘要】目的:比较高、低浓度HBsAg阳性人群乙型肝炎病毒核酸(HBVDNA)与乙型病毒肝炎标志物(HBVM)含量之间的差异,揭示低浓度HBsAg人群HBVDNA与HBVM之间的特点。方法:对264例慢性HBV感染者的HBsAg浓度(高浓度HBsAg组、低浓度HBsAg组)及自然史(免疫耐受期、免疫清除期、非活动期)进行分组,采用实时荧光聚合酶链反应(PCR)和微粒子酶免疫试验(ME

2、IA)对147例低浓度HBsA组和117例高浓度HBsAg组的血清标本进行HBVDNA和HBVM的定量测定并进行比较。结果:低浓度HBsAg组免疫耐受期7例、免疫清除期4例血清标本HBVDNA、抗HBs、HBeAg、抗HBe之间的差异存在统计学意义(t=2.531～9.181,P<0.01～0.05),非活动期136例血清标本中有94.1%(128/136)HBVDNA处于105copies/L以下,直接法PCR、浓缩法PCR对HBVDNA检出率分别为10.3%(14/136)、10.3

3、%(47/136),且HBVDNA与HBVM各指标之间均不存在相关性(P>0.05);高浓度HBsAg组免疫耐受期25例HBVDNA与HBeAg、抗HBe存在相关性(r=0.744～0.772,tr=3.858～4.207,P<0.01),免疫清除期46例和非活动期46例HBVDNA则仅与抗HBs存在负相关性(r=-0.693～-0.598,tr=-4.616～-3.936,P<0.01～0.05)。结论:低浓度HBsAg人群具有特殊的血清学特点,10可能与机体免疫耐受及免疫系统

4、个体化反应有关。【关键词】乙型肝炎病毒标志物;慢性HBV感染;乙型肝炎表面抗原［Abstract］AIM:ToanalyzethequantitativedifferencesbetweenhepatitisBvirusmarkers(HBVM)andHBVDNAinpopulationwithhighlevelorlowlevelHBsAg,andtorevealthecharacteristicsofHBVDNAandHBVMinpopulationwithlowlevelHBsAg.M

5、ETHODS:Atotalof264chronicHBVinfectedpatientswereenrolledinourstudy,andweredividedintolowlevelHBsAggroup(147cases)andhighlevelHBsAggroup(117cases)basedontheHBsAglevelorweredividedintoimmunetolerancestage,immuneclearancestageandnonactivestagebasedon

6、thenaturalhistory.RealtimePCRandmicroparticleenzymeimmunoassay(MEIA)wereusedtodeterminethecontentofHBVDNAandHBVMinserumsamplesofhighlevelandlowlevelHBsAgpatients,respectively,thenthequantitativeresultswerecompared.RESULTS:Therewerestatisticallysign

7、ificantdifferencesbetweenHBVDNAandHBVM(antiHBs,HBeAgandantiHBe)oflowlevelHBsAgpatientsinimmunetolerancestage(7cases)andimmuneclearancestage(4cases)(t=2.531-9.181,10P<0.01-0.05).HBVDNAlowerthan105copies/Lwasfoundin94.1%(128/136)ofserumsamplesinno

8、nactivestage,andthedetectionratesofdirectPCRandenrichingPCRwere10.3%(14/136)and10.3%(47/136)inlowlevelHBsAggroup,respectively,andtherewerenocorrelationsbetweenHBVDNAandeachofHBVM(P>0.05).InhighlevelHBsAggroup,HBVDNAwaspositivelycorrelate