中国西南地区慢性乙型肝炎自然病程中HBV基因型和定量血清学标记物的特征分析.doc

中国西南地区慢性乙型肝炎自然病程中HBV基因型和定量血清学标记物的特征分析 史立伟，向 瑜，黄世峰，文阳安，张莉萍 （400016 重庆，重庆医科大学附属第一医院检验科） [摘要] 目的 探讨西南地区慢性乙型肝炎(chronic hepatitis B，CHB)病毒感染者自然病程中HBV基因分型和定量血清生物标记物的特点。方法 收集2009年3月1日至2009年5月31日我国西南地区140例CHB患者临床资料和全血标本，根据HBV感染自然病程的四个时期：免疫耐受 (immune-tolerance, IT) 期、免疫清除(immune clearance, IC)期、低复制(low-replication, LR)期和再活动(reactivation phase, RE)期分为四组，采用巢式PCR法进行HBV分子基因分型，化学发光微粒子免疫分析法进行HBV血清学标记物定量检测。结果 CHB患者的HBV基因型以B2和C2为主，且B型患者病情更具进展性；血清HBsAg水平的中位数以IT组最高，LR组最低(P0.01)；相关性分析显示HBsAg水平与HBV-DNA、HBeAg、患者年龄、ALT及AST水平显著相关：在IC、LR、RE组HBsAg水平与HBV-DNA呈显著正相关(R=0.337，P=0.012；R=0.580，P=0.006；R=0.451，P=0.007)；在RE组中HBsAg与ALT和AST均呈正相关(R=0.985， P=0.001；R=0.992，P=0.001)。结论 HBV基因分型和血清学指标定量检测可能有助于预测HBV相关疾病的远期进展。 [关键词] HBV基因型；定量免疫分析；慢性乙型肝炎病毒感染 [中图法分类号] R512.6 [文献标识码] A Characterization of molecular genotypes and quantitative serological markers in patients during natural phases of chronic hepatitis B infection in southwestern China Shi Liwei Xiang Yu Huang Shifeng Wen Yang-an Zhang Liping ( Department of Laborory Medicine, First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China ) [Abstract] Aim: To systematically characterize the molecular genotypes and quantitative serological biomarkers during the natural course of chronic hepatitis B infection (CHB) in patients in southwestern China. Methods: Collected the clinical data and whole blood samples of 140 CHB patients from southwestern China, and grouped according to the natural four phases of HBV-infection: immune tolerance, immune clearance, low replicative and reactivation phase. Nested PCR was used for HBV molecular genotyping and chemiluminescent microparticle immunoassay for quantitative serological detection. Result: Subgenotypes B2 and C2 were found to be most prevalent with genotype B patients showing a more progressive disease. Median HBsAg-levels was highest in IT-group and lowest in LR-group (p0.001). Correlation analysis showed significant correlation between HBsAg-levels and HBV-DNA, HBeAg, age,