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目的探讨慢性乙型肝炎(CHB)不同组合模式的HBeAg、HBeAb与血清、唾液HBV-DNA之间关系及其在临床、流行病学上的意义。方法用荧光聚合酶链反应(FQ-PCR)精确定量、配对检测200例慢性乙型肝炎患者血清、唾液HBV-DNA含量;以电化学发光免疫法检测血清HBeAg、HBeAb水平。结果HBeAg(+)、HBeAb(-)模式血清、唾液HBV-DNA检出率分别为96.75%、83.22%,均值为7.02±1.31、4.92±1.44logcopies/ml,与其余模式比较均有明显差异(P<0.001)。HBeAg水平与血清、唾液HBV-DNA水平间呈明显正相关(r分别为0.48、0.40;P均<0.001);HBeAg(-)、HBeAb(+)模式中,血清、唾液HBV-DNA检出率分别为67.44%、39.53%,均值为4.84±1.89、3.51±1.29logcopies/ml。HBeAg(-)、HBeAb(-)模式中,血清HBV-DNA检出率也达到66.67%,均值为4.64±2.06log拷贝/ml。结论HBeAg(-)、HBeAb(+)CHB患者,其血清、唾液中有很高的HBV-DNA检出率,临床、流行病学上仅以HBeAg作为复制的血清学指标,来判断HBV复制和评估传染性有明显局限性,需结合HBV-DNA的检测。
Objective To explore the relationship between HBeAg, HBeAb and serum and salivary HBV-DNA in different combination modes of chronic hepatitis B (CHB) and its clinical and epidemiological significance. Methods Serum and saliva HBV-DNA levels in 200 patients with chronic hepatitis B were detected by fluorescence quantitative polymerase chain reaction (FQ-PCR). The levels of HBeAg and HBeAb in serum were detected by chemiluminescence immunoassay. Results The detection rates of HBV-DNA in serum and saliva of HBeAg (+) and HBeAb (-) were 96.75% and 83.22% respectively, with mean values of 7.02 ± 1.31 and 4.92 ± 1.44logcopies / ml, respectively, P <0.001). The levels of HBeAg in serum and saliva were positively correlated with HBV-DNA levels (r = 0.48,0.40, P <0.001, respectively). In HBeAg (-) and HBeAb Respectively, 67.44%, 39.53%, mean 4.84 ± 1.89,3.51 ± 1.29logcopies / ml. HBeAg (-), HBeAb (-) mode, the detection rate of serum HBV-DNA also reached 66.67%, with an average of 4.64 ± 2.06log copies / ml. Conclusions HBeAg (-) and HBeAb (+) CHB patients have a high detection rate of HBV-DNA in serum and saliva. Only HBeAg is used as a serological marker in clinical and epidemiological studies to determine HBV replication and Evaluation of Infectious There are obvious limitations, the need for detection of HBV-DNA.