乙型肝炎病毒前S2抗原/抗体检测方法的改进及其应用

Improvement of the assay for Pre S2 Ag/Ab detection and its application in different patients

通过改进乙型肝炎病毒表面前Ｓ２抗原（Ｐｒｅ－Ｓ２Ａｇ）、前Ｓ２抗体（Ｐｒｅ－Ｓ２Ａｂ）的检测方法，对１２８份正常人标本Ｐｒｅ－Ｓ２Ａｂ进行测定，确定了Ｐｒｅ－Ｓ２Ａｂ抑制率的阳性界值。用改进后的方法检测不同人群中的Ｐｒｅ－Ｓ２Ａｇ及Ｐｒｅ－Ｓ２Ａｂ，发现在慢性乙型肝炎患者中Ｐｒｅ－Ｓ２Ａｇ比ＨＢｅＡｇ／Ａｂ系统更能反映机体的ＨＢＶＤＮＡ复制水平（Ｐ＜０．０１），而Ｐｒｅ－Ｓ２Ａｂ的检出则与急性乙型肝炎的预后密切相关，同时，Ｐｒｅ－Ｓ２Ａｂ也可作为评价含有Ｐｒｅ－Ｓ２Ａｇ的乙肝疫苗主动免疫效果的指标。

A new ELISA inhibition test for measuring serum Pre S2Ab was developed to avoid the “double positive” phenomenon. One hundred and twenty samples with Pre S2Ab negative were detected for Pre S2Ab, the critical range for Pre S2Ab in normal population was confirmed: a positive result was decided while the inhibition ration was over 50%, a negative result was decided while the inhibition ratio was less than 34%, and a dubious result was decided while the ratio was over 34% but less then 50%. At the same time, serum samples from sixty patients with chronic hepatitis B were detected for Pre S2Ag and Pre S2Ab, it showed that (1) the positive ratio of HBV DNA in patients with Pre S2Ag positive was much higher than in patients with Pre S2Ag negative (P<0.01); (2) to the 46 patients with HBV DNA positive, Pre S2Ag had a better relationship with HBV DNA than the HBeAg/Ab did (P<0.01). Furthermore, to patients with acute hepatitis B, the presence of Pre S2Ab was closely related to the prognosis of the disease, and the Pre S2Ab assay could also be used to evaluate the preventive effect of HB vaccine containing Pre S2Ag.