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目的 探讨慢性乙型肝炎肝内炎症与 HBV-DNA定量的关系 ,为临床正确估计肝内炎症提供依据。方法 应用荧光定量PCR法检测 74例慢性乙肝患者血清中 HBV-DNA的含量 ,同时行肝穿刺病理检查。结果 在 HBs Ag阳性患者中 ,HBV-DNA的水平与 Scheuer分级无相关性 ,提示 HBV-DNA的含量与肝内炎症活动程度无关。但是 ,在 HBe Ab阳性患者有相关性 ,HBe Ag阳性者中则无。结论 慢性乙型肝炎患者 ,如果不是在免疫耐受期 ,HBV-DNA复制水平与肝内炎症活动程度是相关的。由于 HBV-DNA复制水平的增高先于 ALT升高 ,检测 HBV-DNA含量可能更有助于选择治疗的时机。
Objective To investigate the relationship between intrahepatic inflammation and HBV-DNA in chronic hepatitis B, and to provide a basis for the correct assessment of intrahepatic inflammation in clinical practice. Methods The levels of HBV-DNA in sera of 74 patients with chronic hepatitis B were detected by real-time fluorescence quantitative PCR, and the pathological examination of liver biopsy was performed at the same time. Results There was no correlation between the level of HBV-DNA and the Scheuer grade in HBsAg-positive patients, suggesting that the content of HBV-DNA was not related to the degree of intrahepatic inflammatory activity. However, there was a correlation between HBeAb-positive patients and none among HBeAg-positive patients. Conclusions In patients with chronic hepatitis B, if not during immune tolerance, the level of HBV-DNA replication correlates with the degree of intrahepatic inflammatory activity. As the level of HBV-DNA replication precedes the elevation of ALT, detection of HBV-DNA levels may be more helpful in choosing the timing of treatment.