乙肝病毒载量与血清标志物及ALT相关性研究

探讨了乙型肝炎病毒核酸(HBV-DNA)水平与乙型肝炎免疫标志物(HBVM)和丙氨酸氨基转移酶(ALT)的关系。分别采用实时荧光定量聚合酶链反应(FQ-PCR),酶联免疫法和连续监测法检测了345例血清标本HBV-DNA含量,HBVM(HBsAg、HBsAb、HBeAg、HBeAb、抗HBcIgM)表达及ALT水平。HBsAg、HBeAg(和抗HBcIgM)阳性患者HBV DNA阳性率要明显高于HBsAg、HBeAb(和抗HBcIgM)阳性患者、仅HBsAg阳性患者及HBsAb、HBeAb阳性患者(P<0.01)。血清HBeAg阳性标本HBV-DNA阳性率为98.7%,明显高于HBeAg阴性标本的61.6%(P<0.01),并且血清HBeAg阳性标本HBV-DNA含量(log值,7.42±1.43)也明显高于HBeAg阴性标本(4.36±1.73)(P<0.01);在HBV-DNA含量小于107copy/mL的标本中,ALT与HBV-DNA含量呈正相关(P<0.01)。血清中HBV DNA含量与乙型肝炎免疫标志物以及肝细胞损伤三者之间存在密切的关系,在临床工作中应对血清HBVM、ALT和HBV-DNA含量联合检测,这样才能更准确地判断患者病情、预后及指导抗病毒药物的应用。

Correlativity among Hepatitis B Viral Load Quantification, Serum Markers and Alanine Aminotransferase

Correlativity of hepatitis B viral(HBV) load quantification,serum markers,and alanine aminotransferase(ALT) was studied.345 sera were examined by fluorescence real-time quantitative polymerase chain reaction(FQ-PCR) for the HBV serum markers and successive monitor reaction for the concentration of ALT.The results showed that in HBsAg,HBeAg(and HBcIgM) positive patients the positive rate of HBV-DNA is higher than in HBsAg,HBeAb(and HBcIgM) positive patients(P<0.01);Both HBV-DNA load quantification and positive rate in HBeAg positive samples are higher than in HBeAg negative samples(P<0.01);When HBV-DNA <10~7 copy/mL,there is a direct correlation between the quantification of HBV-DNA and the concentration of ALT.Therefore,there is a certain correlation among HBV-DNA quantification,serum markers,and ALT.But the ALT cannot increase with the number of virus,and serum markers are not authentic markers that show the replication of HBV.It is necessary to examine them together.