血清乙型肝炎病毒表面抗原大蛋白检测的临床意义与评价

Evaluation and clinical significance of HBV large protein （LHBs） in diagnosis of hepatitis B

目的通过对乙型病毒性肝炎（乙肝）患者血清中乙肝表面抗原大蛋白（LHBs）、HBVDNA、乙肝前S1（PreSl）及传统的乙肝两对半的检测与平行比较研究，探讨LHBs用于临床诊断乙型肝炎的意义。方法检测385例乙肝患者的血清标本，LHBs、PreSl及乙肝两对半采用酶联免疫方法，HBVDNA检测采用实时荧光定量PCR法。结果307份HBVDNA阳性标本中LHBs的阳性率（86．97％）明显高于PreSl的阳性率（49．5％），两者差异有统计学意义（P〈0．05）；LHBs含量与HBVDNA拷贝数呈正相关性，r=0．935；HBeAg阴性标本中LHBs的检出率为76．92％，比较HBVDNA的检出率（67．95％）无统计学意义；PreSl的检出率（45．73％）则明显低于LHBs和HBVDNA。结论乙肝患者血清中LHBs表达与HBVDNA拷贝数呈正相关，两者的检出率与符合率均高于PreSl，LHBs检测可以用于反映乙肝患者病毒复制的血清免疫学指标。

Objective To explore the significance of HBV large protein （LHBs） in diagnosis of hepatitis B, we detected the LHBs, HBV DNA, PreS1 and other hepatitis B viral markers （HBV M ） in the serum of patients infected with HBV. Methods HBV DNA was quantitatively detected using RT-PCR, LHBs, PreS1 and HBV M were analyzed by ELISA in totally 385 serum samples. Results There was a significant difference between the positive rate of LHBs （ 86.97 % ） and PreS1 （49.5 % ） in the 307 serum positive for HBV DNA （ P 〈 0.05）. There was a correlation between the levels of LHBs and the logarithm of HBV DNA （ r = 0.935）. In the serum specimens of patients negative for HBeAg, there was no significant difference between the positive rate of LHBs （76.92%） and the HBV DNA （67.95%）, but the positive rate of PreS1 （45.73%） was lower than that of LHBs or HBV DNA. Conclusion There was a close correlation between the copies of HBV DNA and the levels of LHBs, both the positive rate and the coincidence rate of LBHs and HBV DNA were higher than those of PreS1. LHBs can reflect the replication status of HBV.