人巨细胞病毒IgG抗体(ELISA)检测试剂盒稳定性观察

目的观察人巨细胞病毒(human cytomegalovirus,HCMV)IgG抗体(ELISA)检测试剂盒的稳定性。方法将HCMV IgG抗体(ELISA)检测试剂盒分别以不同时间放置于2~8℃和37℃,检测试剂盒的外观、阳性参考品符合率、阴性参考品符合率、重复性和检测限,并对其进行稳定性(实时稳定性、加速破坏稳定性、开瓶稳定性、运输稳定性)的观察及初步应用。结果 3批实验用试剂盒实时稳定性和3批试生产试剂盒加速破坏稳定性、开瓶稳定性、运输稳定性试验中,外观均合格,阴性参考品符合率及阳性参考品符合率均为100%,最低检出限参考品均能检出。3批实验用试剂盒实时稳定性检测重复性良好,CV值均≤15.00%。3批试生产试剂盒在37℃条件下放置6 d后,CV值分别为7.94%、7.16%、4.66%;开瓶后分别置于2~8℃冰箱0w、1w、2w、3w、4w,CV值均≤1 5.00%;运输至上海,CV值分别为2.59%、3.12%、2.37%;运输至海南,CV值分别为4.89%、2.65%、2.33%。样品反复冻融5次后,试剂盒检测稳定性良好。结论 HCMV IgG抗体(ELISA)检测试剂盒具有良好的稳定性,在2~8℃条件下至少可保存15个月。     

巨细胞病毒IgG抗体检测试剂盒(酶联免疫法)的性能验证

目的:对本公司研制的人巨细胞病毒(HCMV)Ig G抗体检测试剂盒(酶联免疫法)的性能进行验证。方法:应用间接法研制HCMV Ig G抗体检测试剂盒(酶联免疫法),对的3批试剂盒的阴性参考品符合率、阳性参考品符合率、重复性、检测限、批间差等技术指标进行评价,并用1050例样本进行比对试验,结果进行Kappa检验、χ~2检验。结果:3批试剂盒阴性参考品符合率、阳性参考品符合率、检测限、重复性、批间差均达到要求。同时,经中国食品药品检定研究院检定,3批试剂盒所检项目全部合格。比对试验敏感度为98.92%,特异性为98.60%,与已上市试剂盒的总符合率为98.83%,Youden指数为0.9752,Kappa系数为0.9710,一致性优,χ~2检验P0.05。结论:制备了HCMV Ig G抗体检测试剂盒,可应用于临床监测、诊断及预后判断。     

免疫渗滤法检测血液及尿液HIV抗体的应用评价

评价免疫渗滤法人类免疫缺陷病毒1+2型抗体诊断试剂盒检测人血浆和尿液样本的临床性能。采用对照试验研究,选取背景清晰的研究对象200例,采集同一研究对象的血浆和尿液样本,应用万泰生物药业公司生产的人类免疫缺陷病毒1+2型抗体诊断试剂盒作为考核试剂,法国生物梅里埃公司生产的人类免疫缺陷病毒抗体诊断试剂盒(ELISA法)作为参考试剂进行检测,考核试剂检测结果与参考试剂及研究对象背景进行比较分析。考核试剂检测血浆HIV抗体与参考试剂相比较,阳性符合率100.00%,阴性符合率100.00%,总符合率100.00%,Kappa值1.00,一致性强度为最强;考核试剂检测尿液HIV抗体与参考试剂检测结果相比较,阳性符合率68.29%,阴性符合率100.00%,总符合率87.00%,Kappa值0.72,一致性强度为高度。免疫渗滤法人类免疫缺陷病毒1+2型抗体诊断试剂盒对血浆、尿液样本检测性能优越,适合临床快速诊断。     

布鲁菌抗体检测试剂盒稳定性的研究

目的评估布鲁菌抗体检测试剂盒(试管凝集法)的质量稳定性,在产品注册时提交模拟运输条件相关研究资料,即由2～8℃冷链运输条件变更为常温2～30℃(不超过6 d)运输。方法用连续3批次布鲁菌抗体检测试剂盒(试管凝集法)试剂,对其进行模拟运输条件试验,同时进行热加速稳定性、开瓶稳定性以及实时稳定性试验,通过观察外观、阳性参考品符合率、阴性参考品符合率、最低检出量和均一性,考察其试剂盒的稳定性。结果模拟运输试验结果显示,布鲁菌抗体检测试剂盒(试管凝集法)在模拟运输2～30℃不超过8 d时,其外观、阳性参考品符合率、阴性参考品符合率、最低检出量及均一性均符合《中华人民共和国药典》2015年版(三部)的检定标准,试剂盒质量稳定。热加速稳定性结果显示,在36～38℃放置不超过6 d时质量稳定;开瓶稳定性结果显示,开瓶后12周内质量稳定。连续3批次试剂实时稳定性在试剂盒效期后一个月检测结果仍合格。结论布鲁菌抗体检测试剂盒(试管凝集法)具有良好的稳定性,运输条件由2～8℃冷链运输可变为2～30℃不超过6 d的常温运输;在2～8℃试剂盒可保存12个月,开瓶后在12周内质量稳定,产品于2018年1月份在国家药品监督管理局完成注册,运输条件的变更获得批准。     

淋病奈瑟菌核酸检测试剂盒国家参考品的制备

目的制备淋病奈瑟菌(Neisseria gonorrhoeae,NG)核酸检测试剂盒国家参考品。方法分别将10株NG和10株非NG参考菌株在各自适宜的培养基和温度下培养,收获新鲜无污染培养物,用比浊法和显微计数法将不同的培养物制备成10份NG菌悬液阳性参考品、5份精密性参考品和10份非NG菌悬液阴性参考品以及最低检出限参考品,然后利用5种不同来源的NG核酸检测试剂盒验证各种参考品,并考察参考品在不同处理条件下的稳定性。结果每株菌在各自适宜的培养基和温度下培养后,均生长良好,无杂菌污染。经5种试剂盒验证检测,10份阳性参考品的检测结果均为阳性,10份阴性参考品的检测结果均为阴性,精密性参考品检测结果为Ct值的CV均小于5.0%;5种试剂盒的最低检出限均能达到1 000/m L,其中试剂盒B和E的最低检出限达100/m L。参考品在2~8℃放置7 d、3 7℃放置3 d的热稳定性及反复冻融5次以内的稳定性良好。结论制备的NG核酸检测试剂盒国家参考品的准确性、特异性及精密性均符合要求,可用于NG核酸检测试剂盒的质量评价。     

EB病毒衣壳抗原IgM抗体检测试剂参考品的建立

目的 建立EB病毒衣壳抗原IgM抗体检测试剂国家参考品并制定质量标准。方法 收集并筛选EB病毒衣壳抗原IgM抗体阳性和阴性血浆样本,建立EB病毒衣壳抗原IgM抗体检测试剂国家参考品并进行均匀性和稳定性研究,经10个实验室的协助标定,确定参考品的质量标准。结果 建立的EB病毒衣壳抗原IgM抗体检测试剂国家参考品包括阳性参考品6份、阴性参考品10份、重复性参考品1份和检测限参考品3份。参考品均匀性变异系数(coefficient of variation,CV)为3.1%,满足行业标准CV≤15.0%的要求;2～8℃放置7 d、室温放置3 d和反复冻融3次对参考品均无影响。质量标准为：阳性符合率应≥4/6,阴性符合率应为10/10,重复性(2个浓度水平)的检测结果应均为阳性且CV均≤15.0%,检测限参考品L1应为阳性,L2～L3不作要求。结论 建立的EB病毒衣壳抗原IgM抗体检测试剂国家参考品可用于相关试剂研发的质量控制及评价。     

人巨细胞病毒IgM抗体国家参考品的研制

目的为了对人巨细胞病毒(Human cytomegalovirus,HCMV)IgM抗体检测试剂进行统一评价,研制HCMVIgM抗体国家参考品,用于控制试剂盒的质量。方法收集正常人与感染者的标本,采用多实验室联合标定的方法确认参考品的试验结果,并经一系列的破坏条件进行稳定性和均匀性考核。结果考核的敏感性和准确性符合国家参考品的要求。结论该参考品能用于临床检测试剂的质量控制。     

A族链球菌核酸检测试剂国家参考品的研制

目的研制A族链球菌核酸检测试剂国家参考品。方法将10株A族链球菌株和10株非A族链球菌参考菌株分别在各自适宜的培养基和温度下培养,收获新鲜培养物进行计数、灭活、稀释和分装,并对参考品进行均匀性和稳定性评估。采用A族链球菌核酸检测试剂对阳性参考品符合率、阴性参考品符合率、重复性和最低检出限进行了适用性验证,并组织4家实验室开展了协作标定。结果建立了由10个阳性参考品、10个阴性参考品、最低检出限参考品和重复性参考品组成的A族链球菌核酸检测试剂评价用国家参考品。经评估该参考品具有良好的均匀性及稳定性,协作标定结果显示阳性参考品符合率、阴性参考品符合率、重复性参考品均符合要求,最低检出限参考品菌液浓度两家实验室标定为1×10~4个/mL,两家实验室标定为1×10~3个/mL。结论研制的参考品可以用于A族链球菌核酸检测试剂的质量评价。     

人类免疫缺陷病毒1／2型抗体检测酶联免疫试剂盒的研制

采用二聚体合成肽（ＨＩＶ－１ｇｐ４１、ｇｐ１２０、ｐ２４和ＨＩＶ－２ｇｐ３６）包被酶标板条制备成固相抗原,与鼠抗人ＩｇＧ单克隆抗体酶标记物、底物ＴＭＢ及阴阳性参考血清配套制备成ＨＩＶ抗体ＥＩＡ试剂盒,专供检测人血清或血浆ＨＩＶ１／２抗体之用。以荷兰、韩国及万泰试剂作为对照,用该试剂盒对检定所的Ｐａｎｅｌ标准及献血员１５５５０例（其中ＨＣＶ抗体阳性１２８例,ＨＢｓＡｇ阳性４６例）进行检测,四种试剂对检定所Ｐａｎｅｌ标准的１３份阳性血清均呈阳性反应,２８份阴性血清均为阴性;献血员１５５５０例,四种试剂对其中１份血清均呈阳性反应,经Ｗｅｓｔｅｒｎｂｌｏｔ试验证实为阴性,四种试剂的阴性检出率均为９９．９９％。连续制备三批试剂经中国药品生物制品检定所检定,所检项目全部合格;同时委托检定所进行临床考核,４７份阳性血清全部呈阳性反应,１５０份阴性血清全部为阴性。说明该试剂盒具有很好的敏感性和特异性。     

新生儿巨细胞病毒感染的检测

建立了用ELISA检测巨细胞病毒(HCMV)IgA抗体的方法,並用于检测北京地区100对母婴的HCMV抗体,母血、脐带血、母乳中HCMV-IgG抗体的阳性率分别为83％,75％和38％,HCMV-IgA抗体的阳性率分别为19％,15％和58％,对其中的16名婴儿半年后追踪观察,5名出生时母、脐血全为阴性的,有2名抗体阳转。8名出生时母、脐血均阳性的,有1名IgA仍阳性並检查发现肝大肋下二指。另1名IgG持续阳性,其他6名婴儿抗体转阴。3名出生时母血HCMV-IgG阳性者中,1名婴儿IgA和‘gG转阳,此时母亲IgA也阳转。随访的16名婴儿中有3名可能是生后半年内受HCMV感染。     

正常顺产儿与早产儿人巨细胞病毒和风疹病毒脐带血清抗体检测分析

通过间接酶联免疫法检测178份新生儿(正常顺产儿为114例,早产儿64例)脐带血血清中人巨细胞病毒(human cytomegalovirus,HCMV)和风疹病毒(rubella virus,RV)IgG和IgM抗体,并分析所测结果与临床表现的相关性。结果表明,178例新生儿脐带血血清中HCMV-IgG阳性标本为168例(94.38%),HCMV-IgM阳性标本为1例(0.56%);RV-IgG阳性标本为119例(66.85%);RV-IgM阳性标本为1例(0.56%)。其中,正常顺产儿脐带血中HCMV-IgM和RV-IgM阳性率均为0.87%(1/114),HCMV-IgG阳性率为94.73%(108/114),RV-IgG阳性率为61.40%(70/114),HCMV和RV IgG两者均阳性者为55.26%(63/114);早产儿HCMV-IgM和RV-IgM均为阴性(0/64),HCMV-IgG阳性率为93.75%(60/64),RV-IgG阳性率为76.56%(49/64),HCMV和RV IgG两者均阳性者为70.31%(45/64)。早产儿与正常顺产儿比较,早产儿的RV-IgG阳性率和HCMV和RV-IgG两者均阳性者均高于正常顺产儿,且差异有统计学意义(P<0.05)。可见,HCMV感染率较高,至今仍无有效的HCMV疫苗,应加大疫苗研发力度。所查新生儿RV-IgG阳性率为66.48%,提示中国33%以上的育龄期妇女有在孕早期暴露感染的机率,国家有必要加大该种疫苗的接种力度。     

Genetic association of crown rust resistance gene Pc68, storage protein loci, and resistance gene analogues in oats

Segregating F(3) families, derived from a cross between oat cultivar Swan and the putative single gene line PC68, were used to determine the association of seed storage protein loci and resistance gene analogues (RGAs) with the crown rust resistance gene Pc68. SDS-PAGE analysis detected three avenin loci, AveX, AveY, and AveZ, closely linked to Pc68. Their diagnostic alleles are linked in coupling to Pc68 and were also detected in three additional lines carrying Pc68. Another protein locus was linked in repulsion to Pc68. In complementary studies, three wheat RGA clones (W2, W4, and W10) detected restriction fragment length polymorphisms (RFLPs) between homozygous resistant and homozygous susceptible F(3) DNA bulks. Four oat homologues of W2 were cloned and sequenced. RFLPs detected with two of them were mapped using F(3) and F(4) populations. Clone 18 detected a locus, Orga2, linked in repulsion to Pc68. Clone 22 detected several RFLPs including Orga1 (the closest locus to Pc68) and three RGA loci (Orga22-2, Orga22-3, and Orga22-4) loosely linked to Pc68. The diagnostic RFLPs linked in coupling to Pc68 were detected by clone 22 in three additional oat lines carrying Pc68 and have potential utility in investigating and improving crown rust resistance of oat.     

黄牛（Bos taurus）基因组P450基因家族的分析

利用黄牛基因组cDNA和氨基酸数据库对P450基因进行搜索和分析,结果显示：在黄牛基因组中发现64个P450基因,分别属于18个P450家族和38个亚家族。以氨基酸序列相似度大于60％为标准对黄牛P450基因进行分组,32个为孤儿基因,其余32个可归入9个组,其中7个组适合于正选择和基因转换分析。结果表明：有3个组显著受到正选择压力作用,其中的2个组有正选择概率大于95％的氨基酸位点,分别位于底物识别位点SRS1和SRS2;有5个组显示显著的基因转换事件;既显著受到正选择压力作用,又参与基因转换的基因共4个。可见,发生基因转换的基因与受到显著正选择的基因有一定的相关性。此外,鉴定出20个不同的基序,其中有6条基序在90％以上的基因中出现。     

Induction of rat hepatic drug metabolizing enzymes by dimethylcyclosiloxanes

Low molecular weight dimethylcyclosiloxanes (DMCS) are important precursors in the synthesis of polydimethysiloxane polymers widely used in industry, and in medical and personal care products. The objective of this study was to characterize the ability of two DMCS, octamethylcyclosiloxane (D4) and decamethylcyclopentasiloxane (D5) to induce drug metabolizing enzymes in rats. Male and female Sprague-Dawley rats were administered 1, 5, 20, or 100 mg/kg D4 or D5 in corn oil daily by gavage for 4 days. Changes in the levels of activity and/or immunoreactivity of CYP1A1/2, CYP2B1/2, CYP3A1/2 and NADPH cytochrome P450 reductase in liver microsomes were examined. Significant increases were observed in the liver to body weight ratio in female rats administered either D4 or D5 at doses > or = 20 mg/kg. Increases in the liver to body weight ratio were observed in male rats treated with > or = 100 mg/kg D5 but not with D4. Relatively large increases in CYP2B1/2 enzymatic activity and immunoreactive protein were observed with increasing concentrations of both D4 and D5. Significant increases in 7-pentoxyresorufin O-depentylase (PROD) activity were also detected in male and female rats given D4 at doses > or = 5 mg/kg. D5 increased PROD activity in male rats at doses > or = 20 mg/kg and in female rats at doses > or = 5 mg/kg. 7-Ethoxyresorufin O-deethylase (EROD) activity was increased in both male and female rats receiving > or = 20 mg/kg D4 or > or = 5 mg/kg D5; however, no changes were detected in CYP1A1/2 immunoreactive protein in rats of either sex. D4 and D5 caused significant increases in CYP3A1/2 immunoreactive protein in only male rats treated with 100 mg/kg of either compound. However, significant increases were detected in CYP3A1/2 immunoreactive protein in female rats at D4 doses > or = 20 mg/kg and D5 doses > or = 5 mg/kg. Induction of NADPH cytochrome P-450 reductase immunoreactive protein was observed with D4 in female rats and in both male and female rats with D5. Induction of CYP2B/1/2, CYP3A1/2 and NADPH cytochrome P450 reductase was observed in rats treated with 50 mg/kg phenobarbital by intraperitoneal injection. Maximal CYP2B induction detected with D4 was approximately 50% of the increase observed with phenobarbital. In summary, D4 and D5 induced CYP2B1/2 in adult rat liver in a manner similar to that observed with phenobarbital; however, differences were observed between D4 and D5 in their ability to induce CYP3A1/2 and NADPH cytochrome P450 reductase. Female rats were more sensitive to the inductive properties of low doses of both DMCS than male rats whereas male rats were more responsive to phenobarbital induction.     

Development of a microtitre plate indirect ELISA for measuring cortisol in teleosts, and evaluation of stress responses in rainbow trout and gilthead sea bream

A microtitre plate indirect enzyme‐linked immunoassay (ELISA) was developed for measuring plasma cortisol levels in rainbow trout Oncorhynchus mykiss, gilthead sea bream Sparus auratus sea bass Dicentrarchus labrax and Senegalese sole Solea senegalensis. Covalink microplates pretreated with disuccinimidyl suberate were coated with bovine serum albumin (BSA) conjugated to cortisol‐3‐carboxymethyl oxime. After blocking with BSA, competition was started by addition of plasma samples and anti‐cortisol antibody raised in rabbit. Goat anti‐rabbit IgG conjugated‐peroxidase was added as second antibody and then incubated with orthophenylenediamine as substrate. Reaction was stopped with 0·1 M HCl and absorbance was read at 450 nm in an automatic plate reader. The standard curve was linear from the lower limit of sensitivity of the assay (c. 0·3 ng ml^?1) to c. 3000 ng ml^?1. Dose‐response inhibition curves using serially diluted plasma samples of four species consistently showed parallelism with the standard curve using cortisol. The ELISA satisfied the strictest criteria of specificity (cross‐reactivity of anti‐cortisol antibody with testosterone, progesterone and 17ß‐oestradiol was negligible, cross‐reactivity with cortisone, corticosterone and 11‐deoxycortisol, was 1·5, 1 and 0·1%, respectively), reproducibility (interassay CV <6%), precision (intra‐assay CV <4%), and accuracy (average recovery >98%). Plasma cortisol concentration in rested fishes was in the range of 5–30 ng ml^?1. To physiologically validate the technique, changes in plasma cortisol concentrations were also measured in plasma of rainbow trout and gilthead sea bream following an acute 15 min chasing or 3 min air‐exposure stress, respectively. In both species plasma concentrations of cortisol, glucose and lactate rose significantly with respect to controls, showing concentrations similar to those reported previously for these species under similar stress conditions. Furthermore, gilthead sea bream chronically stressed by maintaining for 14 days under increased stocking density conditions also showed increased concentrations of plasma cortisol and glucose. These results validate the indirect ELISA technique developed for use in the evaluation of plasma cortisol concentration of at least four fish species.     

Dried Blood Spot Sampling for Hepatitis B Virus Serology and Molecular Testing

Background & Aims

Dried blood spots (DBS) on filter paper have been successfully used to diagnose and monitor several infectious diseases. The aim was to investigate the performance of DBS in hepatitis B virus (HBV) diagnosis using commercial tests in comparison to standard methods.

Methods

Paired DBS and plasma samples were collected from 200 patients: 100 patients with HBsAg negative status and 100 patients with HBsAg positive status. In the latter patient, HBeAg reactivity was tested. Ten samples of anti-HBs were collected from people vaccinated against HBV. We also studied 50 patients with positive HBV DNA viral load in plasma and 10 HBV DNA negative patients. HBV genotypes and gene polymerase mutations were determined in 10 randomly selected HBV-infected patients. The DBS sample consisted of 50 µL of whole blood, i.e. a 12-mm paper card.

Results

The sensitivity thresholds of HBsAg and anti-HBs antibody were 0.30±0.08 IU/mL and 18.11±6.05 IU/mL, respectively, for DBS with 98% sensitivity and 100% specificity. Sensitivity was 98% and specificity 100% for the detection of HBV DNA on a blotter, considering an HBV DNA threshold of 914.1±157.8 IU/ml. Ten patients had an HBeAg positive status in plasma, all were detected positive using DBS. HBV genotyping and mutation detection were successfully performed on DBS, with full concordance between the 10 paired DBS and plasma samples.

Conclusion

This study shows DBS is a reliable alternative to plasma specimens for quantifying and detecting HBsAg, anti-HBs, HBeAg and genotyping. DBS may increase the opportunities for HBV testing and treatment follow-up in hard-to-reach individuals.     

A liquid chromatographic-electrospray ionization-tandem mass spectrometric method for determination of buprenorphine,its metabolite,norbuprenorphine, and a coformulant,naloxone, that is suitable for in vivo and in vitro metabolism studies

A liquid chromatographic-electrospray ionization-tandem mass spectrometric method has been developed and validated for determination of the antiabuse medication, buprenorphine, its primary metabolite, norbuprenorphine, and a proposed coformulant, naloxone. The method uses deuterated internal standards and a simple liquid-liquid extraction. Mass spectrometry employed selected reaction monitoring of the transitions of m/z 468 to 396 for buprenorphine, 472 to 400 for [2H4]buprenorphine, 414 to 101 for norbuprenorphine, 423 to 110 for [2H9]norbuprenorphine, 328 to 310 for naloxone, and 345 to 327 for its internal standard, [2H3]naltrexone. The method was accurate and precise across the dynamic range of 0.1 to 10 ng/ml. All analytes were stable in human plasma stored at room temperature for up to 24 h and after three freeze-thaw cycles. Reconstituted extracts were stable at -20 degrees C for up to 3 days. In human subjects receiving a sublingual tablet of 8 mg buprenorphine and 2 mg naloxone, buprenorphine and norbuprenorphine were detected for up to 24 h with respective maximum concentrations at 1 and 1.5 h. Maximal concentrations ranged from 2.2 to 2.8 and 1.5 to 2.4 ng/ml for buprenorphine and norbuprenorphine, respectively (i.e., approximately 6 nM). The method detected norbuprenorphine formation in human liver microsomes incubated with 5-82 nM buprenorphine, which encompasses the therapeutic plasma concentration range. When cDNA-expressed P450s were incubated with 21 nM buprenorphine, norbuprenorphine formation was detected for P450s 3A4, as previously described, but also for 3A5, 3A7, and 2C8. Buprenorphine utilization generally exceeded norbuprenorphine formation, suggesting that P450s 2C18, 2C19, 2D6, and 2E1 may also be involved in buprenorphine metabolism to other products. These results suggest this method is suitable for both in vivo and in vitro studies of buprenorphine metabolism to norbuprenorphine.     

乙型肝炎血清标志模式与病毒载量的关系及意义

为探讨乙型肝炎 (以下简称乙肝 )血清标志模式与病毒载量的关系及临床意义 ,作者选择符合 2 0 0 0年《全国病毒性肝炎诊断标准》的慢性肝炎血清 1343份 ,分别用ELISA法、PCR ELISA法检测HB血清标志、HBV -DNA和 1896位点变异株。结果显示 :HBsAg阳性血清 10 97份 (81.6 8%、)HBsAg阴性血清 2 4 6份 (81.31% )。在HBsAg阳性血清中 ,HBsAg、HBeAg、抗 HBc(1 3 5 )阳性组 4 0 4份 (30 .l% ) ,HBV -DNA阳性 347份 (85 .89% ) ,DNA阳性值呈递增趋势 (10 4～ 10 6拷贝 /ml,各占 8.6 5 %、33.71%、5 3.6 1% ) ;而HBsAg、抗 HBe阳性组血清 6 0 6份 (45 .12 % ) ,DNA阳性值 10 5拷贝 /ml,占优势 (6 4 .18% )。在HBsAg阴性血清中 ,抗 HBs、抗 HBe、抗 HBc(2 4 5 )阳性组 2 32份 (17.2 7% ) ,DNA阳性占 7.32 % ,DNA阳性值递减由 10 4～ 10 6拷贝 /ml,各占 5 2 .9%、4 1.l%、5 .9%。结论 ,各血清标志模式中的病毒载量为HBsAg阳性组 >HBsAg阴性组 ,阳性组 1 3 5 >1 4 5 >l 5 >2 4 5。但 1 3 5阳性组中 14 %在界值以下 ,1 4 5阳性组中 1896位点自然变异达 78.6 % ,2 4 5阳性组中仍存在DNA+ 血清 ,以上提示在临床判定和治疗时要慎重对待(注 :l=HBsAg,2 =抗 HBs,3=HBeAg ,4 =抗 HBe ,5 =抗 HBc)