乙型肝炎病毒前S1蛋白检测的临床意义

The Clinical Significance of Pre-S1 Protein in HBV Detection

目的探讨乙肝前S1抗原和“乙肝六项”、HBV-DNA的关系并结合ALT的变化确定前S1抗原的临床意义和诊断价值。方法采用ELISA方法检测前S1和乙肝六项,荧光定量PCR法检测HBV-DNA,采用紫外连续监测法检测谷丙转氨酶(ALT)。结果“大三阳”标本中前S1阳性率为85.2%,HBV-DNA阳性率为90.3%;“小三阳”中前S1阳性率为46.4%,HBV-DNA阳性率为31.6%;HBSAg+、HBCAg+、e系统为阴性的前S1阳性率为26.9%,HBV-DNA的阳性率为23.0%。急性乙肝跟踪观察前S1、HBV-DNA、ALT时发现前S1能够较早反应乙肝恢复情况。ALT恢复越快前S1抗原转阴越早,且先于DNA阴转。结论前S1蛋白能够较好地反映乙肝病毒的复制情况,对病情的预后和疗效判断有较好的临床应用价值。

Objective: To investigate the relationship of pre-S1,6 modes of HBV and HBV-DNA,and determine the clinical significance and diagnostic value of pre-S1 combining with the change of ALT.Method: Pre-S1 and 6 modes of HBV were detected by ELISA.HBV-DNA was detected by fluorescence quantitative polymerase chain reaction method.ALT was detected by ultraviolet repeated monitor method.Results: In HBsAb, HBeAg and HBcAb positive samples, positive rate of pre-S1 was 85.2%, HBV-DNA was 90.3%.While in HBsAg, HBsAb and HBcAb positive samples, positive rate of Pre-S1 was 46.4%, HBV-DNA was 23.0%.In HBsAg and HBcAg positive while HBeAg and HBeAb negative samples, positive rate of Pre-S1 was 26.9%, HBV-DNA was 23.0%. Tracing Pre-S1, HBV-DNA and ALT of the people with acute hepatitis B in 1, 3 and 6 months, we found that the quicker ALT normalized, the earlier Pre-S1 became negative, and earlier than that of DNA.Conclusion: Pre-S1 is a good indicator of HBV replication.It was useful in the prognosis evaluation and in the therapeutic efficiency evaluation.