乙肝病毒大蛋白检测在乙型肝炎诊治中的临床意义

Clinical significance of serum hepatitis B virus large surface protein in diagnosis and treatment of patients with hepatitis B

目的:探讨乙肝病毒(HBV)大蛋白(LP)在乙型肝炎诊治中的临床意义．方法:对162例HBV感染者YL47A正常对照血清采用酶联免疫吸附试验检测HBV-LP,HBV 前S1抗原,HBV前S2抗原及乙型肝炎血清标志物:FQ-PCR定量检测HBV DNA．结果:在HBV感染组中,HBV-LP与HBV DNA,HBeAg,HBVpreS2,HBVpreS1间相关显署(X2=9．22,11．89,60．35,99．87;均P<0．01),其含量与HBV DNA拷贝数成正相关(rs=0．64, P<0．001),不同HBV DNA拷贝数组别间HBV- LP含量存在差异显著性(X2=135．34,P<0．01); HBeAg,HBV DNA,HBVpreS2,HBVpreS1不同模式间HBV-LP含量及阳性率均存在差异显著性(Z=8．70,5．85,8．44,8．84,均P<0．001); HBeAg阴性感染血清中HBV-LP较HBV DNA, HBVpreS2,HBVpreS1更为敏感(76．8％)．HBV 感染组与正常对照组间HBV-LP含量存在差异显著性(P<0．01)．结论:HBV-LP是从蛋白水平反映HBV感染者体内病毒复制程度的可靠指标,尤其是 HBeAg阴性患者体内病毒复制及预后判断的良好血清学监测指标．

AIM： To discuss the clinical significance of hepatitis B virus large surface protein （HBVLP） detection in the diagnosis and treatment of patients with hepatitis B. METHODS： Enzyme-linked immunosorbent assay was used to measure the levels of serum HBV-LP, HBV preS1, HBV preS2 and HBV markers, and fluorescence quantitative-polymerase chain reaction （FQ-PCR） was used to detect HBV DNA in 162 patients with hepatitis B as well as 47 normal controls. RESULTS： In serum samples of the patient with HBV infection, the level of HBV-LP had significant correlation with that of HBV DNA, HBeAg1 HBVpreS2 and HBVpreS1 antigen （x^2 = 9.22, 11.89, 60.35, 99.87; all P〈0.01）. The contents of serum HBV-LP was positively correlated with HBV DNA copies （rs = 0.64, P〈0.001）. The level of serum HBV-LP was also significantly different between the groups with different HBV DNA copies （P〈0.01）. The level and positiverate of serum HBV-LP were significantly different between HBV DNA-positive and negative patients （Z= 5.85, P〈0.001）, and they were in the same situation for HBeAg, HBVpreS2 and HBVpreS1 antigen （Z = 8.70, 8.44, 8.84; all P〈0.001）. The serum HBV-LP was more sensitive than HBV DNA, HBVpreS2 and HBVpreS1 antigen in HBeAg-negative patients （76.8%）. Serum HBV-LP was significantly different between the patients with HBV infection and normal controls （P〈O.Ol）. CONCLUSION： HBV-LP may serve as a reliable marker in the reflection of HBV replication at protein level, and it is valuable to monitor HBV replication and prognosis of the disease, especially in HBeAg-negative HBV infected patients.