慢性乙肝肝细胞HBcAg与血清病毒学指标之间的相关性研究.docVIP

慢性乙肝患者肝细胞HBcAg分布与血清病毒学指标的相关性研究 唐奇远1 何清*1 乐晓华1 吕德良2 张香梅1 敖飞健1 唐怡敏1 黄珊1 1广东医学院附属深圳第三人民医院(广东 深圳 518020) 2深圳市慢性病医院(广东 深圳 518020) 【摘要】 目的 探讨慢性乙肝患者肝细胞HBcAg分布规律与血清病毒学指标的相关性。 方法 对958 例慢性乙肝患者的血清学、病毒学、免疫组化等资料进行对比分析。 结果 在肝细胞内HBcAg不同分布类型的各组之间，血清HBeAg阳性率及HBV-DNA载量均存在显著性差异（P＜0.001)。其中，此两项指标以HBcAg核型和混合型分布组最高， HBcAg检测阴性组最低，而HBcAg 浆型分布组的HBeAg阳性率及HBV-DNA载量则介于上述两组之间。 结论 HBcAg在受染肝细胞内的分布与血清病毒学指标之间具有明显的相关性，随着HBcAg分布态势由受染肝细胞核向细胞浆漂移并最后不能检测，HBeAg阳性率及HBV-DNA载量呈逐渐降低的趋势。 【关键词】 慢性乙肝 HBcAg　HBeAg HBV-DNA载量 The relationship between HBcAg in hepatocytes and the serum virological index in the patients with chronic hepatitis B [Abstract] Objective：To study the relationship between subcellular localization of HBcAg and the serum index of virology in the patients with chronic hepatitis B. Methods：958 patients with chronic hepatitis B were collected. The data of serology, virology and immunohistochemistry were respectively compared and analyzed in these patients. Results：The significant difference was determined in the positive rate of HBeAg among the groups with different subcellular localizations of HBcAg（P＜0.001）. significant difference was also found in the load of HBV-DNA among them（P＜0.001）.nuclear distribution and mixed distribution of HBcAg but a gradual decrease of them among the groups with the cytoplasmic distribution of HBcAg and the lowest ones among the groups with negative HBcAg. Conclusion：There is a significant relationship between the subcellular localization of HBcAg and the serum virological index. With HBcAg shifting from nuclei to cytoplasm and being deleted finally, the gradual decrease will be detected in the positive rate of HBeAg and load of HBV-DNA. Key Words Chronic hepatitis B；HBcAg; HBeAg; the load of HBV-DNA 通讯作者: 何清, Email: heqingjoe@163.net 前言 乙肝病毒核心抗原(HBcAg)是一种由乙肝病毒DNA的C区编码的蛋白质，其在慢性乙肝患者肝细胞内的分布状态不尽相同，按病理学免疫组化检查的结果，根据其在肝细胞内分布部位不同分为核型(分布在细胞核)、浆型（分布在细胞浆）和混合型（分布在细胞核以及细胞浆），在部分患者的肝细胞内则表现为HBcAg的缺如。目前对于HBcAg不同分布的患者，其乙肝病毒血清学指标特点的研究，尚缺乏大样本的文献报道。 本文拟通过对958例的慢性乙肝肝活检患者临