不同血清学模式乙肝患者前S1抗原的临床意义

The clinical significance of the PreS1 antigen in the HBV infected patients of different serologic models

目的:探讨前S1抗原在血清学模式HBsAg+、HBeAg+ /Anti-HBe+和Anti-HBC+患者中的临床意义。方法:检测199例HBsAg+、HBeAg+和Anti-HBC+(“模式1”), 185例HBsAg+、Anti-HBe+和Anti-HBC+(“模式2”)患者标本的HBV-DNA前S1抗原和肝功能相关指标ALT、GGT。结果: 199例“模式1”标本中HBV-DNA阳性189例(阳性率95 .0% ),前S1抗原阳性86例(阳性率43. 2% )、肝功能异常33例(异常率38 .37% ),前S1抗原与HBV-DNA阳性率不相关(P>0 .05), 前S1抗原阳性率与肝功能异常率不关联(P>0. 05 ); 185例“模式2”标本中HBV-DNA阳性94例(阳性率50 .81% ),前S1抗原阳性54例(阳性率29. 2% )、肝功能异常35例(异常率68 .81% ),前S1抗原阳性率与HBV-DNA阳性率相关(P<0 .05), 前S1抗原阳性率与肝功能异常率有关联(P<0 05)。结论:前S1抗原在“模式2”患者中能反映乙肝病毒复制,可作为肝功能损害的参考指标;但在“模式1”患者中不能反映乙肝病毒复制和作为肝功能损害的参考指标。

Objective:To discuss the clinical significance of the PreS1 antigen in the HBV infected patients of different serologic models.Methods:HBV-DNA, PreS1 antigen, ALT and GGT were determined in 199 patients of HBsAg+, HBeAg+ and Anti-HBC+(Model 1) and 185 patients of HBsAg+, Anti-HBe+ and Anti-HBC+(Model 2).Results:189 HBV-DNA and 86 PreS1 antigen and 33 hepa-dysfunction were found in the 199 patients of Model 1 and 94 HBV-DNA, 54 PreS1 antigen and 35 hepa-dysfunction were found in the 185 patients of Model 2.PreS1 antigen was not correlated with HBV-DNA and hepa-dysfunction in the patients of Model 1, and PreS1 antigen was correlated with HBV-DNA and hepa-dysfunction in the patients of Model 2.Conclusion:PreS1 antigen could be taken as the copy indicator of HBV and as a referencing indicator of the injury of the liver in the patients of Model 2, and could not be taken as that in the patients of Model 1.