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探讨乙型肝炎病毒(HBV)表面抗原转阴后的患者血浆乙肝病毒DNA存在的时间及临床意义。应用定量聚合酶链反应技术对浙江省浦江县中医院诊治的64例乙型肝炎表面抗原转阴,乙型肝炎病毒标志物仍为阳性的患者进行检测,观察HBsAg转阴后HBV DNA存在于血清中的时间;同时检测每例患者肝功,观察患者HBV DNA转阴前后肝功能的变化,以及HBV DNA转阴时间与患者肝功能的关系。64例患者在2~168周内先后出现HBV DNA转阴,HBV DNA转阴率100%;其转阴中位时间为26周。两组患者HBV DNA转阴后肝功能均有改善(P<0.05)。对比HBV DNA转阴时间较短组(A组)与较长组(B组)肝功能改善情况,A组总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)前后对比,其t值分别为:2.47,3.97,3.56;B组TBIL、ALT、AST前后对比,其t值分别为:2.65,4.32,3.71,A组明显较B组改善更大(P<0.05)。乙肝患者HBsAg转阴后HBV DNA可在血清中存在数周至数年,HBV DNA的转阴方可认为乙肝治愈,HBV DNA转阴后肝功可明显改善,且HBV DNA的转阴时间与患者病程相关,并对患者肝功及预后产生影响。
To investigate the time and clinical significance of the presence of hepatitis B virus DNA in patients after hepatitis B virus surface antigen negative conversion. Quantitative polymerase chain reaction (PCR) was used to detect 64 patients with hepatitis B surface antigen negative and hepatitis B virus markers still positive in the diagnosis and treatment of Pujiang County Hospital of Zhejiang Province. HBV DNA was observed in serum At the same time testing each patient’s liver function, observe the changes of liver function in patients before and after HBV DNA negative, and the relationship between HBV DNA negative time and liver function. Sixty-four patients had HBV DNA negative within 2 ~ 168 weeks, and the negative rate of HBV DNA was 100%. The median time to negative conversion was 26 weeks. The liver function of HBV DNA in both groups was improved after negative conversion (P <0.05). Comparing the improvement of hepatic function between the shorter HBV DNA negative group (group A) and the longer group (group B), the level of total bilirubin (TBIL), alanine aminotransferase (ALT), aspartate (T = 2.47,3.97,3.56, respectively). The t values of TBIL, ALT and AST in group B were 2.65, 4.32 and 3.71, respectively. The A group was significantly better than the B group Larger (P <0.05). HBsAg in patients with hepatitis B after negative HBV DNA can exist in the serum for several weeks to several years, HBV DNA negative side can be considered hepatitis B cure, HBV DNA negative after liver function can be significantly improved, and HBV DNA negative time and patient duration Related, and liver function and prognosis of patients have an impact.