高灵敏度real-time PCR在低病毒载量病毒性肝病中的临床应用价值

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Abstract Objective To evaluate the clinical application value of high-sensitivity real-time polymerase chain reaction (real-time PCR) in the quantitative detection of viral nucleic acid in viral hepatitis, and to provide the basis for the widespread application of this method. Methods A total of 895 patients with viral hepatitis were enrolled from January 2016 to December 2018 in Hubei Provincial Hospital of Traditional Chinese Medicine (hereinafter referred to as “our hospital”), and meanwhile another 100 normal people in our hospital were recruited as control group. Serum viral loads were detected by routine and high sensitive real-time PCR, then the difference of results between the two methods was compared. The trends and characteristics of biochemical indices，immunological markers, international standardized ratio of coagulation (INR), index of liver fibrosis FIB-4 and their correlation with viral load were analyzed statistically in viral hepatitis patients with low viral load. Results The proportion of patients with low viral load was high among the population surveyed. The positive rate of HBV DNA detected by real-time PCR with high sensitivity was much higher than that by routine method（P ＜ 0.05），but for HCV RNA, the two methods showed good consistency. The fluctuation of several biochemical indices was not obvious in low viral load patients, and multiple biochemical indexes were not correlated with viral nucleic acid load (P ＞ 0.05). Most hepatitis B patients with low viral load showed a status of low level HBeAg-negative replication. There were different degrees of inconsistency and weak correlation between immunological diagnostic markers and viral load results. INR of coagulation and FIB-4 index of liver fibrosis in patients with low viral load were higher than those in the control group, and the difference was statistically significant (P ＜ 0.05), but there was no correlation between them and viral nucleic acid load (P ＞ 0.05). Conclusion High sensitivity real-time PCR has incomparable advantages in the detection of viral nucleic acid，combined with other diagnostic markers，it can play an irreplaceable role in the course management of low viral load hepatitis.

Key words： High sensitivity Real-time polymerase chain reaction Viral hepatitis Viral nucleic acid quantification Low viral load

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	CHEN Peng1 SUN Yuliang1 DENG Xing1 XIAO Mingzhong2

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CHEN Peng1 SUN Yuliang1 DENG Xing1 XIAO Mingzhong2. Clinical application value of high-sensitivity real-time PCR in low load viral hepatitis[J]. 中国医药导报, 2020, 17(19): 151-155.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2020/V17/I19/151

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