乙型肝炎病毒前S1、前S2抗原及e抗原与病毒DNA之间的相关分析

Analysis of the correlation between PreS1-Ag,PreS2-Ag,HBeAg and HBV DNA in the serum of chronic hepatitis B patients

目的探讨乙型肝炎病毒(HBV)血清学标志物及 HBV DNA 之间的相关性。方法应用定量 PCR 内标法检测 HBV DNA,筛选出100例未经干扰素和核苷(酸)类似物治疗、丙氨酸氨基转移酶(ALT)/天冬氨酸氨基转移酶(AST)正常且 HBV DNA 阳性的慢性乙型肝炎患者。用微粒子酶免分析法、ELISA 方法检测乙肝血清学标记物。筛选出40名健康人作为质控对照。结果 HBV DNA阳性乙肝患者:(1)乙肝 e 抗原(HBeAg)阳性率为75%;乙肝 e 抗体(抗-HBe)阳性率25%;乙肝前 S1抗原(PreS1-Ag)阳性率为69%;乙肝前 S2抗原(PreS2-Ag)阳性率为77%;(2)75例 HBeAg 阳性患者中 PreS1-Ag 阳性54例,PreS2-Ag 阳性60例;25例抗-HBe 阳性患者中 PreS1-Ag 阳性14例,PreS2-Ag阳性17例。PreSl一Ag、PreS2-Ag 阳性率在两种情况下的差异均无统计学意义(均 P>0.05);(3)HBeAg阳性时,PreS1-Ag、PreS2-Ag 均阴性的阴性率(8%)低于抗-HBe 阳性时的阴性率(28%),差异有统计学意义(P<0.05);(4)PreS1-Ag 与 PreS2-Ag 同为阳性、阴性的72例。结论慢性乙型肝炎患者 HBeAg、PreS1-Ag、PreS2-Ag 阳性与 HBV-DNA 阳性的符合率较高。PreS1-Ag、PreS2-Ag 阳性率与HBeAg 的阳性无明确相关。PreS1-Ag、PreS2-Ag 阴性率与抗-HBe 阳性有较好的相关性。

Objective To investigate the correlation between the serum indices and HBV DNA. Methods 100 chronic HBV patients and 40 healthy controls were enrolled in this study. The patients have not received any treatment with interferon （IFN） and similar nucleotide, and featured with normal ALT/ AST, positive HBV DNA examined by using internal-quantitative standard PCR. Serum indices were measured by micro-particle enzyme immunoassay analysis and ELISA. Results In chronic HBV patients with positive HBV DNA, the positive percentage were 75% for HBeAg, 25% for anti-HBe, 69% for PreS1- Ag, and 77% for PreS2-Ag. In 75 HBeAg positive cases, there were 54 cases of PreS1-Ag positive and 60 cases of PreS2-Ag positive; while among anti-HBe positive cases, there were 14 cases of PreS1-Ag positive and 17 cases of PreS2-Ag positive. There was no significant difference of the positive percentage of PreS1-Ag and PreS2-Ag between HBeAg positive and anti-HBe positive （both P 〉 0. 05 ）. Under circumstance of HBeAg positive, the percentage of both PreS1-Ag and PreS2-Ag negative （ 8% ） was significant lower than that of anti-HBe positive （28%） （P 〈 0.05 ）. There were 72 cases with consistent positive or negative for both PreS1-Ag and PreS2-Ag. Conclusion For hepatitis B patients with positive HBV DNA, the differences of positive percentages for HBeAg, PreS1-Ag and PreS2-Ag are moderate. The positive percentages of PreS1-Ag and PreS2-Ag do not correlate with HBeAg positive. The negative percentages of PreS1-Ag and PreS2-Ag correlate with anti-HBe positive.