e抗原阴性慢性乙肝患者血清表面抗原大蛋白、PreS1蛋白、PreS2蛋白与HBV-DNA检测分析

Detection of serum hepatitis B virus large envelope protein,PreS1-Ag,PreS2-Ag and HBV-DNA in patients with HBeAg-negative chronic hrpatitis B

目的:通过检测HBeAg阴性慢性乙肝患者血清表面抗原大蛋白(HBV-LP)、PreS1蛋白、PreS2蛋白和HBV-DNA比较分析,以探讨血清乙肝大蛋白检测对于HBeAg阴性慢性乙肝患者在临床诊治中的价值和意义。方法:采用ELISA法检测247例HBeAg阴性慢性乙肝患者HBV-LP、PreS1蛋白、PreS2蛋白,并应用实时荧光定量PCR技术平行检测HBV-DNA。结果:247例HBeAg阴性慢性乙肝患者HBV-DNA阳性率51.0%,血清HBV-LP阳性率66.4%,PreS1蛋白阳性率22.3%,PreS2蛋白阳性率34.0%,血清中HBV-LP阳性率明显高于PreS1蛋白和PreS2蛋白阳性率,差异均有显著性(P均<0.01)。结论:HBeAg阴性慢性乙肝患者检测其血清HBV-LP较PreS1蛋白和PreS2蛋白更敏感反映体内HBV感染和复制状态,HBV-LP更有利于HBeAg阴性慢性乙肝患者的疗效观察和预后判断。

Objective：To evaluate the significance of the HBV - LP detection to the diagnosis and treatment of the patients with HBeAg - negative chronic hepatitis B. Methods ： HBV - LP, PreS1 - Ag and PreS2 - Ag were detected with ELISA while HBV - DNA with RT - PCR in 247 serum samples collected from patients of HBeAg - negative chronic hepatitis B. Results： The positive rate of HBV- DNA, HBV- LP, PreS1 -Ag and PreS2 -Ag was 51.0%, 66.4%, 22. 3% and 34. 0% , respectively, in 247 cases. The positive rate of HBV - LP was higher than PreS1 - Ag and PreS2 - Ag. There is significant difference （ P 〈 0.01 ）. Conclusion ：The level of serum HBV - LP could reflect the state of HBV infection and replication, which is more sensitive than PreSl - Ag and PreS2 - Ag in the patients with HBeAg - negative chronic hepatitis B. The level of serum HBV - LP is much more valuable to monitor the treatment and prognosis of the patients with HBeAg - negative chronic hepatitis B.