乙型肝炎病毒表面抗原阳性孕妇前S1抗原检测分析

Analysis of the application of preS1Ag in pregnant women with positive HbsAg

目的检测乙型肝炎表面抗原(HbsAg)阳性孕妇血清乙型肝炎前S1抗原(PreS1Ag)与乙肝病毒DNA(HBV DNA)的结果,探讨PreS1Ag在妇幼保健工作的使用价值。方法对288名HbsAg阳性孕妇血清用酶联免疫吸附法检测PreS1Ag,用荧光定量PCR法检测HBVDNA。结果288名HbsAg阳性孕妇PreS1Ag总阳性率为76.4%(220/288)、PCR总阳性率为82.6%(238/288);HbeAg(-)血清学模式组PreS1Ag阳性率为73.4%(160/218)、HbeAg(+)血清学模式组PreS1Ag阳性率为85.7%(60/70),两组PreS1Ag阳性率无显著性差异(P>0.05);PCR(-)组PreS1Ag阳性率为26%(13/50)、PCR(+)组PreS1Ag阳性率为87%(207/238),两组PreS1Ag阳性率有显著性差异(P﹤0.05)。结论PreS1Ag与HBeAg无明确相关,与HBVDNA有较好的一致性,基层妇幼保健机构可通过检测PreS1Ag补充了解孕妇乙肝病毒的复制状态,做好防治措施。

Objective To discuss the significance of detecting preS1Ag in the process of maternal and child health care by comparing the preS1Ag and HBV DNA detection rates in HbsAg positive pregnant women.Methods ELISA was applied to determine the serum preS1Ag in 288 pregnant women with positive HbsAg, and the HBV DNA was determined by PCR. Results The detection rates of preS1Ag and HBV DNA were 76.4%（220/288） and 82.6%（238/288） respectively. The detection rate of preS1Ag in the HbeAg negative group was 73.4%（160/218）, while it was 85.7%（60/70） in the HbeAg positive group. The difference between them had no statistical significance （P〉0.05）. The detection rate of preS1Ag in the HBV DNA negative group was 26%（13/50）, while it was 87%（207/238） in the HBV DNA positive group. The difference between them had statistical significance （17〈0.05）. Conclution There is no consistent between the existence of preS1Ag and HbeAg, and there is high consistent between the preS1Ag and HBV DNA. The basic maternal and child health care can observe the replication of HBV by detecting preS1Ag and take responsive measure in prevention and cure.