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目的 寻求HBVDNA和HBeAg、ALT的相关性及其临床意义。 方法 采用branchDNA法动态检测 5 9例慢性乙肝患者HBVDNA15 8例次 (下称bDNA) ,同时检测HBeAg、ALT。 结果 (1)bDNA >2 0 0 0MEq/ml仅 8例次 ,占5 .1% ,而bDNA <2 0 0 0MEq/ml15 0例次 ,占 94.9%。 (2 )HBeAg阳性时 ,bDNA >10MEq/ml,肝功能多数异常 (85 .5 % ) ;反之 ,肝功能多数正常 (62 .3 % )。 (3 )HBeAg阴性时 ,bDNA >10MEq/ml,肝功能全部异常 (10 0 % ) ;反之 ,肝功能多数正常 (82 .8% )。结论 (1)不同bDNA值反映患者不同感染程度和自身清除能力的代数和。 (2 )HBeAg阳性 ,bDNA持续波动在 10MEq/ml以上 ,患者处于隐性或显性活动状态 ,反之处于稳定期。 (3 )HBeAg阴性 ,bDNA <10MEq/ml且ALT正常提示处于稳定期 ;反之可能是变异株感染或是抗HBeAg正在转换中。前者仍需抗病毒治疗 ,后者应动态观察。 (4 )动态观察HBeAg阳性、ALT升高未予特殊治疗 13例患者 ,其bDNA波动亦十分明显。因此反复检测、动态观察bDNA的变化 ,方能正确评估其价值。
Objective To investigate the relationship between HBVDNA, HBeAg and ALT and its clinical significance. Methods HBVDNA15 was detected in 58 cases of chronic hepatitis B (bDNA) by using the method of branchDNA and HBeAg and ALT simultaneously. Results (1) bDNA> 20 000MEq / ml was only 8 cases, accounting for 5.1%, while bDNA <2000MEq / ml15 0 cases, accounting for 94.9%. (2) When HBeAg was positive, bDNA> 10MEq / ml, most of the abnormal liver function (85.5%); the other hand, the majority of normal liver function (62.3%). (3) When the HBeAg negative, bDNA> 10MEq / ml, abnormal liver function (100%); the other hand, the majority of normal liver function (82.8%). CONCLUSIONS (1) The algebraic sum of different bDNA values reflecting different degrees of infection and self-clearing ability in patients. (2) HBeAg positive, bDNA continued fluctuations in 10MEq / ml or more, patients in a recessive or dominant activity, whereas in the stable phase. (3) HBeAg-negative, bDNA <10 MEq / ml and normal ALT prompts in stable phase; Conversely it may be variant infection or anti-HBeAg conversion. The former still need antiviral therapy, the latter should be observed dynamically. (4) dynamic observation of HBeAg-positive, elevated ALT 13 patients without special treatment, the bDNA fluctuations are also very clear. Therefore, repeated testing, dynamic observation of bDNA changes, before we can correctly assess its value.