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目的了解本地区近四年乙型肝炎患者HBV DNA阳性率与病毒载量分布特点。方法采用荧光定量聚合酶链反应(PCR)检测2012年至2015年间13 039例HBsAg阳性患者HBV DNA载量,并进一步分析24例HBeAg阳性、31例HBeAg阴性初诊乙肝患者4年间接受正规治疗后HBV DNA变化趋势。结果本地区近4年间血清HBV DNA阳性率依次为48.6%、46.18%、38.69%、37.66%,呈逐年下降趋势,差异具有统计学意义(P<0.01);各年度病毒载量均值的对数值分别为(5.48±1.56),(5.27±1.72),(5.29±1.68),(5.35±1.85)拷贝/mL。2013年、2014年、2015年分别与2012年相比,差异均有统计学意义(P<0.01、P<0.01、P<0.05),而低病毒载量(即病毒拷贝数的对数值小于5拷贝/mL)患者比例2012年明显大于其他年份,2012年分别与2013年、2014年、2015年相比,差异具有统计学意义(P<0.01,P<0.01,P<0.05);HBeAg阳性/阴性乙肝患者接受正规治疗后,其HBV DNA载量均呈逐年下降趋势,其中第一年下降显著(P<0.01)。结论近4年本地区血清HBV DNA阳性率呈逐年下降趋势,且低病毒载量比例明显增加。
Objective To understand the HBV DNA positive rate and viral load distribution in patients with hepatitis B in the past four years in this area. Methods The HBV DNA load of 13 039 HBsAg positive patients from 2012 to 2015 was detected by fluorescence quantitative polymerase chain reaction (PCR) and 24 HBeAg positive patients were further analyzed. Among the 31 HBeAg negative newly diagnosed hepatitis B patients, DNA changes. Results The positive rates of serum HBV DNA in the past four years were 48.6%, 46.18%, 38.69% and 37.66%, respectively, showing a trend of declining year by year, with statistical significance (P <0.01). The logarithm of mean viral load in each year (5.48 ± 1.56), (5.27 ± 1.72), (5.29 ± 1.68) and (5.35 ± 1.85) copies / mL, respectively. Compared with 2012, the difference was statistically significant (P <0.01, P <0.01, P <0.05) in 2013, 2014 and 2015, respectively, whereas the low viral load (ie the logarithm of virus copy number was less than 5 (P <0.01, P <0.05). The proportion of patients with HBeAg positive / positive / negative rate was significantly higher than that of other years in 2012 (P <0.01, P < Negative hepatitis B patients receiving formal treatment, the HBV DNA load showed a downward trend year by year, of which the first year decreased significantly (P <0.01). Conclusions The positive rate of serum HBV DNA in this area has been declining year by year in recent 4 years, and the proportion of low viral load increased significantly.