乙型肝炎病毒X抗原、X抗体检测的临床意义

Clinical significance of detecting hepatitis B virus X antigen and anti-HBx antibody

目的了解乙型肝炎病毒X抗原(HBxAg)、X抗体(HBxAb)在乙型肝炎、肝硬化、肝癌患者血清中的表达情况,探讨HBxAg和HBxAb与上述疾病的相关性和临床意义。方法应用大肠埃希菌合成重组HBxAg,用该抗原免疫动物获得的HBxAb分别包被反应板以酶联免疫吸附试验(ELISA)检测患者(171例乙型肝炎、70例肝硬化和38例肝癌)血清中HBxAg和HBxAb。结果在乙型肝炎、肝硬化、肝癌患者血清中HBxAg和HBxAb阳性率分别为8.8%、18.6%、7.9%和10.5%、47.1%、34.2%,HBxAg在肝硬化患者中检出率较高(P<0.025);与乙型肝炎组比较,HBxAb阳性率在肝硬化和肝癌患者均有显著增高(P<0.005)。结论HBxAg在肝硬化患者检出率较高,而HBxAb则在乙型肝炎后的肝硬化和肝癌患者检出率较高,提示HBxAg和HBxAb可能参与肝组织的免疫病理性损伤过程。

Objective To study the expression of the hepatitis B virus X antigen （HBxAg） and anti-HBx antibody （HBxAb） in the sera from patients with hepatitis B, liver cirrhosis, and hepatocellular carcinoma, and explore the correlation of HBxAg, HBxAb with these diseases and its clinical significance. Methods Recombinant HBxAg which was synthesized in Escherichia coli was used to immunize goat for obtaining HBxAb. Microtiter plates were coated with related antigen and antibody for the detection of HBxAg and HBxAb by enzyme-linked immunosorbent assay （ELISA） in the sera from 171 patients with hepatitis B, 70 patients with liver cirrhosis and 38 patients with hepatocellular carcinoma. Resuits The positive rate of HBxAg in patients with hepatitis B, liver cirrhosis and hepatocelluar carcinoma was 8.8% , 18.6% and 7.9% respectively, while the positive rate of HBxAb was 10.5% , 47.1% and 34.2% respectively. The positive rate of HBxAg in patients with liver cirrhosis was higher （P 〈0. 025 ）. Compared with other serological markers of hepatitis B, the positive rates of HBxAb in patients with liver cirrhosis and hepatocellular carcinoma were significanly higher （P 〈0. 005）. Conclusions HBxAg has a high detection rate in patients with liver cirrhosis, while HBxAb is mainly observed in patients with liver cirrhosis and hepatocellular carcinoma after chronic hepatitis B. The results suggest that HBxAg and HBxAb should be involved in the process of the immunologic and pathologic lesion of liver.