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目的探讨慢性乙型肝炎患者血清乙型肝炎病毒共价闭合环状DNA(HBV cccDNA)的临床意义。方法选取经肝组织病理学诊断的慢性乙型肝炎患者57例,其中乙型肝炎e抗原(HBeAg)阳性37例,HBeAg阴性20例;肝组织炎症轻度33例,肝组织炎症中度24例。采用实时荧光定量聚合酶链反应(FQ-PCR)同时定量检测其血清HBVDNA和cccDNA。结果HBeAg阳性组血清HBV cccDNA对数值和阳性率分别高于阴性组,8.1±1.3vs6.5±1.9,73.0%vs30.0%(均P<0.01)。肝组织炎症轻度组(G1～G2)血清HBVcccDNA对数值低于中度组(G3),7.1±0.4vs8.5±0.4(P<0.01)。血清cccDNA与丙氨酸转氨酶、天冬氨酸转氨酶呈正相关(r=0.612、0.632,均P<0.05)。结论血清HBVcccDNA为病毒复制的标志物,与肝组织细胞损伤相关。
Objective To investigate the clinical significance of hepatitis C virus covalently closed circular DNA (HBV cccDNA) in patients with chronic hepatitis B (HBV). Methods Fifty-seven patients with chronic hepatitis B who were diagnosed by pathological liver biopsy were enrolled, including 37 cases of HBeAg positive and 20 cases of HBeAg negative, 33 cases of mild hepatic inflammation and 24 cases of moderate hepatic inflammation . Real-time fluorescent quantitative polymerase chain reaction (FQ-PCR) was used to detect the serum HBVDNA and cccDNA at the same time. Results The logarithm and positive rate of serum HBV cccDNA in HBeAg positive group were significantly higher than those in the negative group (8.1 ± 1.3 vs 6.5 ± 1.9, 73.0% vs 30.0% respectively) (all P <0.01). The logarithm of serum HBVcccDNA in mild liver inflammation group (G1 ~ G2) was lower than that in moderate group (G3), 7.1 ± 0.4 vs 8.5 ± 0.4 (P <0.01). Serum cccDNA and alanine aminotransferase, aspartate aminotransferase was positively correlated (r = 0.612,0.632, both P <0.05). Conclusion Serum HBVcccDNA is a marker of virus replication and is associated with liver cell injury.