CAJ | 학술논문

目的：分析比较HBV血清标志物HBeAg与抗－HBe同时阳性、同时阴性及单独阳性患者的病毒复制情况。方法采用电化学发光法检测HBV血清标志物，从中筛选出HBeAg与抗－HBe同时阳性或均为阴性以及HBeAg单独阳性或抗－HBe单独阳性的标本，检测该类标本HBV DNA定量值。计数资料组间比较采用χ2检验。结果检测447例患者HBV血清标志物，所有患者HBsAg均为阳性。HBeAg与抗－HBe同时阳性患者32例，阳性率为7．16％，其中HBV DNA＜5×102拷贝／ml占84．38％，5×102拷贝／ml＜HBV DNA＜1×104拷贝／ml占12．50％，1×104拷贝／ml＜HBV DNA＜1×107拷贝／ml占3．13％；HBeAg与抗－HBe同时阳性组的HBV DNA含量分布低于HBeAg单独阳性组，差异有统计学意义（χ2＝13．21，P＜0．01）；抗－HBe阳性组的HBV DNA含量分布低于抗－HBe阴性组（χ2＝74．12，P＜0．01）；HBeAg阴性的患者218例，HBV DNA＞1×104拷贝／ml共9例（4．13％）。结论 HBeAg与抗－HBe同时阳性过去认为是不常见模式，但临床上并不少见，且病毒复制处于较高水平的仍占一定比例；当抗－HBe出现后，病毒复制减弱。血清HBeAg阴性情况下，部分患者病毒仍存在较高水平复制。因此，HBeAg存在与否不能作为抗病毒、疗效评价、传染性强弱的依据。
목적：분석비교HBV혈청표지물HBeAg여항－HBe동시양성、동시음성급단독양성환자적병독복제정황。방법채용전화학발광법검측HBV혈청표지물，종중사선출HBeAg여항－HBe동시양성혹균위음성이급HBeAg단독양성혹항－HBe단독양성적표본，검측해류표본HBV DNA정량치。계수자료조간비교채용χ2검험。결과검측447례환자HBV혈청표지물，소유환자HBsAg균위양성。HBeAg여항－HBe동시양성환자32례，양성솔위7．16％，기중HBV DNA＜5×102고패／ml점84．38％，5×102고패／ml＜HBV DNA＜1×104고패／ml점12．50％，1×104고패／ml＜HBV DNA＜1×107고패／ml점3．13％；HBeAg여항－HBe동시양성조적HBV DNA함량분포저우HBeAg단독양성조，차이유통계학의의（χ2＝13．21，P＜0．01）；항－HBe양성조적HBV DNA함량분포저우항－HBe음성조（χ2＝74．12，P＜0．01）；HBeAg음성적환자218례，HBV DNA＞1×104고패／ml공9례（4．13％）。결론 HBeAg여항－HBe동시양성과거인위시불상견모식，단림상상병불소견，차병독복제처우교고수평적잉점일정비례；당항－HBe출현후，병독복제감약。혈청HBeAg음성정황하，부분환자병독잉존재교고수평복제。인차，HBeAg존재여부불능작위항병독、료효평개、전염성강약적의거。
Objective To analyze and compare the viral replication in patients with hepatitis B virus (HBV)when serum markers HBeAg and HBeAb are both positive,or HBeAg alone is positive,or HBeAb alone is positive,or both are negative.Methods Electrochemiluminescence method was used to detect serum markers of HBV,and the samples with HBeAg and HBeAb being both positive,or HBeAg alone being posi-tive,or HBeAb alone being positive,or both being negative were screened out,and the HBV DNA quantitative values of the samples were de-termined.Comparison of categorical data was made by chi-square test.Results Among 447 patients examined for serum markers of HBV,all were positive for HBsAg.HBeAg and HBeAb were simultaneously detected in 32 cases,with a positive rate of 7.16%.Of the 32 cases, 84.38%had HBV DNA levels of <5 ×102 copies/ml,12.50%had HBV DNA levels between 5 ×102 copies/ml and 1 ×104 copies/ml,and 3.13%had HBV DNA levels between 1 ×104 copies/ml and 1 ×107 copies/ml.The HBV DNA level of the HBeAg/HBeAb-positive group was significantly lower than that of the HBeAg-positive group (χ2 =13.21,P<0.01);the HBV DNA level of the HBeAb-positive group was significantly lower than that of the HBeAb-negative group (χ2 =74.12,P<0.01 ).A total of 218 cases had negative HBeAg,and 9 (4.13%)of them had HBV DNA levels of >1 ×104 copies/ml.Conclusion Being positive for both HBeAg and HBeAb is considered to be rare in the past;however,it is commonly seen clinically,and a proportion of patients have a relatively high level of viral replication.The viral replication weakens when HBeAb appears.In cases of negative serum HBeAg,some patients still show a high level of viral replication.There-fore,the presence or absence of HBeAg cannot be regarded as the evidence in the assessment of antiviral efficacy and infectivity.