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目的检测乙型肝炎所致的终末期肝病患者肝移植前、后血清乙型肝炎病毒(HBV)DNA的含量,探讨HBV再感染的检测方法。方法采用荧光定量聚合酶链反应(FQPCR)技术检测275例乙型肝炎所致终末期肝病患者肝移植前以及肝移植后1周、1个月、3个月的血清HBVDNA含量,同时采用酶联免疫吸附试验(ELISA法)检测HBV标志物。结果275例血清标本中,术前乙型肝炎表面抗原(HBsAg)、乙型肝炎核心抗体(抗-HBc)均为阳性;HBsAg、乙型肝炎e抗原(HBeAg)及抗-HBc阳性者的血清HBVDNA均为阳性;HBsAg、乙型肝炎e抗体(抗-HBe)及抗-HBc阳性者73.8%的血清HBVDNA阳性;HBsAg及抗-HBc阳性者67.6%的血清HBVDNA阳性。术后1周患者的HBsAg及HBVDNA均为阴性。术后1个月,69例HBsAg转为阳性,其中48例(69.6%)HBVDNA为阳性。术后3个月,137例HBsAg为阳性,其中104例(75.9%)HBVDNA为阳性。结论乙型肝炎所致的终末期肝病患者肝移植后HBV的再感染率较高,应用FQPCR检测HBVDNA含量能更准确地反映体内HBV的复制情况,可与HBV标志物检测互补。
Objective To detect the content of hepatitis B virus (HBV) DNA in patients with end-stage liver disease caused by hepatitis B before and after liver transplantation and to explore the detection method of HBV reinfection. Methods Serum HBVDNA levels in 275 patients with end-stage liver disease caused by hepatitis B before liver transplantation and 1 week, 1 month and 3 months after liver transplantation were detected by fluorescence quantitative polymerase chain reaction (FQPCR) Immune absorption test (ELISA method) detection of HBV markers. Results Among the 275 serum samples, preoperative HBsAg and anti-HBc were all positive; serum of HBsAg, HBeAg and anti-HBc were positive HBVDNA were positive. Serum HBVDNA was positive in 73.8% of HBsAg, HBeAg and anti-HBc, and 67.6% HBsAg positive in HBsAg and anti-HBc. One week after surgery, HBsAg and HBVDNA were negative. One month after operation, 69 cases of HBsAg turned positive, of which 48 cases (69.6%) were positive for HBVDNA. Three months after surgery, 137 cases of HBsAg positive, of which 104 cases (75.9%) HBVDNA positive. Conclusion The HBV re-infection rate in patients with end-stage liver disease caused by hepatitis B is higher after liver transplantation. The detection of HBVDNA content by FQPCR can more accurately reflect the HBV replication in vivo and can be complementary to the detection of HBV markers.