摘要
目的检测慢性乙型肝炎病毒(HBV)感染者中血清标志物e抗原(HBeAg)与e抗体(抗-HBe)双阳性患者的S/CO区间分布、病毒载量、肝功能状况,并探讨此类模式的产生原因与临床意义。方法收集2015年1月-2016年10月医院慢性乙肝患者血清标本,检测HBV血清标志物,从中筛选出乙型肝炎表面抗原(HBsAg),HBeAg与抗-HBe同时阳性患者的血清标本112例为实验组,HBsAg与HBeAg阳性而抗-HBe为阴性的血清标本60例为对照组1,HBsAg阳性而HBeAg阴性的标本60例为对照组2。分别检测三组标本的HBV-DNA含量,肿瘤标志物甲胎蛋白(AFP)及肝功能状况。结果三组比较,实验组HBeAg的S/CO值明显低于对照组1(P<0.01),主要位于1.0~10.0COI区间内,占62.50%;抗-HBe的S/CO值,以0.5~1.0COI为主,占61.61%;各组HBV-DNA含量差异有统计学意义(P<0.01),多位于1×E+4~1×E+7拷贝/ml之间;实验组人群ALT和AFP异常率明显高于对照组(P<0.05),其中AFP异常率高达31.25%。结论此类血清标志物模式,HBeAg和抗-HBe定量处于中、低水平区间,体内存在动态平衡中的"血清转换";HBV-DNA处于中、低水平复制阶段,传染性降低;然而,肝功能指标和AFP异常率普遍较高,提示肝脏的慢性损伤,应密切关注抗原转换、变异及病毒的复燃,引起相应的重视。
OBJECTIVE To investigate the S/CO quantitative interval,viral replication and liver function of chronic hepatitis B virus（HBV）patients with serum marker e-antigen（HBeAg）and e-antibody（anti-HBe）double positive,and try to discuss the reasons of this kind of mode and clinical significance.METHODS The serum samples of chronic hepatitis B patients of a hospital from Jan.2015 to Oct.2016 were collected.The serum HBV markers were detected,112 cases of HBeAg（＋）and anti-HBe（＋）specimens were selected as experimental group,60 patients of HBsAg（＋）,HBeAg（＋）and anti-HBe（-）specimens were selected as control group 1,and 60 patients of HBsAg（-）and HBeAg（-）were selected as control group 2.The contents of HBV-DNA,the tumor markers of Alpha fetoprotein（AFP）and the status of the liver function of the three groups were detected.RESULTS In experimental group,the S/CO value of HBeAg was significantly lower than that in control group 1（P〈0.01）,which was 62.50%in the range of 1.0~10.0COI,and S/CO value of anti-HBe was mainly 0.5 ~1.0COI,accounting for 61.61%.There was significant differenct in the HBV-DNA content among the three groups（P〈0.01）,which was located in 1×E＋4~1×E＋7copies/ml.The abnormal rates of ALT and AFP in experimental group were significantly higher than those in control group（P〈0.05）,and the abnormal rate of AFP was 31.25%.CONCLUSIONIn the mode of HBeAg and anti-HBe double positive,S/CO value of HBeAg and anti-HBe and HBV-DNA levels are in the middle or low level,but generally high rate of abnormal liver function and AFP values,which indicates the chronic liver injury,so it should pay close attention to HBV antigen conversion,mutation or resurgence,which should be attached great importance.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第19期4332-4335,共4页
Chinese Journal of Nosocomiology
