乙肝表面抗原大蛋白与HBV DNA的比较及其与ALT的关系

Comparison between hepatitis B virus large protein and DNA and its association with alanine aminotransferase level

目的:检测不同模式乙肝患者血清中乙肝表面抗原大蛋白(HBV-LP)、乙肝前S1,HBV DNA以及ALT,比较HBV-LP以及乙肝前S1的检出与HBV DNA及ALT之间的关系,探讨HBV-LP用于乙肝患者临床诊断的意义．方法:采用酶联免疫吸附实验(ELISA)检测177例HBV患者血清HBV-LP和乙肝前S1,荧光定量PCR方法检测患者HBV DNA,全自动生化分析仪检测ALT．结果:相同乙肝模式患者血清HBV-LP与HBV DNA检出率无显著差异;HBeAg阳性患者血清中HBV-LP与HBV DNA阳性率均明显高于HBeAg阴性患者(95．45％vs 44．36％,P<0．05; 93．18％vs 41．35％,P<0．05):相同乙肝模式患者血清乙肝前S1的检出低于HBV DNA的检出,两者差异显著(P<0．05);HBV-LP阳性患者的ALT明显高于HBV-LP阴性患者．结论:乙肝表面抗原大蛋白与HBV DNA有较高的符合率,是反映乙肝患者体内病毒复制情况的可靠指标;而且乙肝表面抗原大蛋白阳性患者ALT较阴性患者高,表明HBV-LP同时也反映了乙肝病情的活动情况．

AIM： To explore the clinical significance of hepatitis B virus large protein （HBV-LP） in the diagnosis of viral replication. METHODS： Serum samples were collected from 177 patients with HBV infection. HBV-LP, HBV preS1 and HBV markers were examined using enzyme linked immunosorbent assay （ELISA）. HBV DNA was quantitatively detected by realtime polymerase chain reaction. The level of alanine aminotransferase was obtained by an automated biochemistry analyzer. RESULTS： No significant difference was found between the detectable rates of HBV DNA and HBV-LP in patient with the same HBV markers. The positive rates of HBV-LP and HBV DNA in HBeAg-positive patients were higher than those of HBeAg negative ones （95,45% vs 44,36%, P 〈 0.05; 93.18% vs 41.35%, P 〈 0.05）. There was significant difference between the detectable rates of HBV DNA and HBV preS1 in patients with the same HBV markers （P 〈 0.05）. The average level of ALT in HBV-LP-positive patients was higher than that of HBV-LP-negative ones. CONCLUSION： There is between the positive rate a perfect correlation of HBV-LP and HBV DNA, and HBV-LP is a reliable serological marker that can reflect the replication of HBV as well as liver function.