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目的:探讨抗病毒治疗的慢性乙型肝病患者外周血白细胞中HBVcccDNA(covalently closed circular DNA)检测的临床价值。方法:采用MEIA法、PCR—微流芯片法检测25例抗病毒治疗的慢性肝病患者和与之匹配的65例未抗病毒治疗慢性肝病患者、3例非乙型肝炎患者血清HBVM、HBVDNA、外周血白细胞中HBVcccDNA。结果:3例非乙型肝炎患者HBVM、HBVDNA、HBVcccDNA均阴性;43.3%(39/90)的慢性肝病患者HBVcccDNA阳性;抗病毒治疗的慢性肝病患者HBVcccDNA阳性率(20.0%)显著低于未抗病毒治疗者(52.3%)(P<0.01),尤其在HBVDNA<10~3copy/ml的慢性肝病患者中(P<0.05)。无论HBeAg+/HBeAb-还是HBeAg-/HBeAb+,抗病毒治疗者HBVcccDNA阳性率均显著低于未抗病毒治疗者(P<0.01、P<0.05)。结论:慢性乙型肝病患者外周血白细胞中有较大比例HBVcccDNA阳性检出率,与血清HBVDNA、HBVM联合检测能提高抗病毒治疗效果判断的准确性。
Objective: To investigate the clinical value of detecting HBVcccDNA (covalently closed circular DNA) in peripheral blood leukocytes from patients with chronic hepatitis B after antiviral therapy. METHODS: The serum levels of HBVM, HBVDNA, peripheral blood (P <0.05), peripheral blood mononuclear cells (PBMCs) and peripheral blood mononuclear cells (PBMCs) were detected by MEIA method and PCR-MCFI method in 25 patients with chronic hepatitis treated with antiviral therapy and matched with 65 patients without antiretroviral therapy for chronic liver disease Blood white blood cells in the HBVcccDNA. Results: HBVD, HBVDNA and HBVcccDNA were all negative in 3 non-hepatitis B patients; 43.3% (39/90) of patients with chronic liver disease were positive for HBVcccDNA; HBVcccDNA positive rate (20.0%) in patients with chronic liver disease treated with anti-virus was significantly lower than that of non-HBV (52.3%) (P <0.01), especially in chronic liver disease with HBVDNA <10 ~ 3copy / ml (P <0.05). The positive rates of HBVcccDNA in patients with antiviral therapy were significantly lower than those without antiviral therapy regardless of HBeAg + / HBeAb- or HBeAg- / HBeAb + (P <0.01, P <0.05). Conclusion: The positive rate of HBVcccDNA in peripheral blood leucocytes of patients with chronic hepatitis B is higher than that of control. Combined with serum HBVDNA and HBVM can improve the accuracy of antiviral therapy.