外周血HBVcccDNA检测的临床应用(1)
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[摘要] 目的 通过对乙型肝炎患者外周血单个核细胞及血浆中共价闭合环状DNA(cccDNA)的检测，初步探讨其外周血检测对乙型肝炎诊治的价值。 方法 将86例确诊为乙型肝炎患者根据病情分为3组，急性乙型肝炎(AHB)、慢性乙型肝炎(CHB)及HBsAg无症状携带者(ASC)组。采集外周血，分别检测ALT、AST、总胆红素(TBIL)、cccDNA、HBV-DNA。 结果 三组血浆cccDNA检测 结果有显著性差异(P<0.01)。单个核细胞cccDNA 7个标本阳性，血浆cccDNA与HBV-DNA、ALT 、AST 、TBIL相关系数分别为0.817、0.402、0.450、0.221。 结论 血浆cccDNA在乙型肝炎患者的各个病程有显著性差异，单个核细胞cccDNA储存池确实存在但浓度较低难以检测。血浆cccDNA与HBV-DNA、ALT、AST相关，但与TBIL无明显相关。
[关键词] 乙型肝炎；HBV-DNA；共价闭合环状DNA
[中图分类号] R512.6+2 [文献标识码] B [文章编号] 1673-9701(2012)02-0064-03
Clinical apply of peripheral blood HBV cccDNA detection
XU Kai1 ZHANG Deting1 ZHENG Jiayong1 LIU Mudan2
1.Wenzhou Third People's Hospital in Zhejiang Province， Wenzhou 325000, China； 2.Wenzhou Medical College, Wenzhou 325000, China
[Abstract] Objective To detect both peripheral blood mononuclear and plasma covalently closed circular DNA(cccDNA) of HBV patients, to investigate peripheral blood cccDNA value for HBV diagnosis and treatment. Methods Divided 86 cases of HBV patients into three groups, acute hepatitis B (AHB), chronic hepatitis B (CHB), HBsAg asymptomatic carriers (ASC) group. Peripheral blood was collected, we detected ALT, AST, TBIL, cccDNA and HBV-DNA, then analyzed the result with SPSS 11.0. Results With rank sum test, there were significant difference for cccDNA among three groups (P<0.01). Seven samples was positive for peripheral blood mononuclear, plasma HBV-DNA and cccDNA, ALT, AST, TBIL correlation coefficients were 0.817, 0.402, 0.450, 0.221. The cccDNA in the plasma of all patients with hepatitis B disease were significantly different, mononuclear cells cccDNA storage pool does exist but it's low and difficult to detect. Conclusion Concentration of plasma cccDNA is related with HBV-DNA, ALT, AST, but no significant correlation with TBIL.
[Key words] Hepatitis B； HBV-DNA； Covalently closed circular DNA
目前临床主要依靠血清学方法检测HBsAg来诊断乙型肝炎感染情况，同时通过HBV-DNA的检测反映病毒复制情况或水平，用于患者病情的监测以及抗病毒疗效。2008年，吴月平[1]等报道了乙型肝炎病毒感染的肝细胞核内可检测到一种不同形式的病毒DNA-共价闭合环状DNA(cccDNA)，它不与蛋白共价结合，是乙肝病毒基因组的复制中间体，是rcDNA(松弛环状DNA)基础上合成的产物，又是前基因组mRNA合成的模板 ......
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