乙型肝炎病毒前S1抗原与病毒DNA检测及相关性研究

Determination and study of the relationship between the Pre-S1 antigen and HBV DNA

目的了解乙型肝炎病毒(HBV)前S1(Pre-S1)抗原在乙肝患者血清中的表达及评判其与HBV复制的关系。方法采用ELISA法检测858例各型乙肝患者血清标志物,以荧光定量PCR法检测HBVDNA,并比较分析Pre-S1抗原、HBeAg与HBV复制的相互关系和临床意义。结果858例各型乙肝患者中,Pre-S1抗原阳性总检出率为30.1%(258/858),HBeAg阳性总检出率为20.7%(178/858),HBVDNA阳性总检出率为43.2%(371/858)。在258例Pre-S1抗原阳性患者中,HBV-DNA阳性检出率为94.1%(243/258),而在371例HBVDNA阳性乙肝患者中,Pre-S1抗原和HBeAg阳性率分别为65.5%(243/371)和45.6%(169/371),两者差异有显著性(P<0.01)。结论Pre-S1抗原能够比HBeAg更灵敏地反映HBV复制,临床上可作为乙肝患者体内HBV复制的重要标志,但其敏感性不如HBVDNA强。

Objective To investigate the situation of expression of Pre-S1 antigen in serum of chronic hepatitis B patients and the effect of these markers on HBV replication. Methods ELISA was used to analyze these serum markers of HBV in 585 chronic hepatitis B patients who were included in this study. HBV DNA was determined by quantitative PCR assay. The relationship of Pre-S1 antigen, HBeAg and the HBV replication was also analyzed, simultaneously. Results The total positive rate of Pre-S1 antigen in these patients was 30.1%, and the HBeAg was just 20.7%, while the HBV DNA reached 43.2%. The positive rate of HBV DNA reached 94. 1% in 258 case patients with Pre-S1 antigen （ ＋ ）. Further, we found that there was a significant difference of positive rate between Pre-S1 antigen and HBeAg in 371 case HBV DNA （ ＋ ） patients. Conclusion Pre-S1 is more sensitive than HBeAg to reflect the HBV replication in chronic hepatitis B patients, but the sensitivity is not more than HBV DNA. Pre-S1 antigen should be regarded as an important marker for HBV replication in clinical diagnosis and therapy.