乙型肝炎病毒大蛋白检测的临床意义

Clinical significance of Hepatitis B Virus large protein checking

目的探讨乙肝患者血清中乙型肝炎病毒大蛋白(Hepatitis B Virus Large Surface Protein,LHBs)检测的临床意义。方法采用酶联免疫吸附实验(ELISA)检测LHBs、乙型肝炎病毒标志物(HBsAg、HBsAb、HBeAg、HBeAb、HB-cAb,HBVM)、乙肝前S1Ag、乙肝前S2Ag;采用荧光定量聚合酶链反应(PCR)法检测HBV-DNA。结果29例HBsAg、HBeAg阳性患者中,LHBs与HBV-DNA阳性检出率比较,差异无显著性意义(P>0.05);乙肝前S1Ag的阳性检出率低于HBV-DNA的阳性检出率,差异有显著性意义(P<0.05);乙肝前S2Ag与HBV-DNA阳性检出率比较,差异无显著性意义(P>0.05);53例HBsAg、HBcAb阳性、HBeAg阴性患者中,LHBs与HBV-DNA阳性检出率比较,差异无显著性意义(P>0.05);乙肝前S1Ag的阳性检出率低于HBV-DNA的阳性检出率,差异有显著性意义(P<0.05);前S2Ag的阳性检出率高于HBV-DNA的阳性检出率,差异有显著性意义(P<0.05);LHBs含量与HBV-DNA拷贝数呈正相关关系(r=0.978,P<0.05)。结论LHBs可反映乙肝病毒的复制情况,特别是HBeAg阴性的患者病毒复制情况;乙肝前S1Ag和乙肝前S2Ag不适合用于判定乙肝病毒的复制水平。

Objective To explore the clinical significance of HBV large protein （LHBs） in diagnosing viral replication m the serum of the patients infected with HBV. Methods LHBs,HBV preS1, HBV preS2, HBsAg,HBeAgHBeAb and HBcAb were analyzed by ELISA. HBV-DNA was quantitatively detected using real-time PCR. Results In 29 patients whose HBsAg and HBeAg were positive ,no significant difference was found in the detection rate of HBV-DNA and LHBs, PreS2 （ P 〉 0. 05 ）. Whereas the detection rate of PreS1 was lower than that of HBV-DNA（ P 〈 0. 05）. In 53 patients who had positive HBsAg and negative HBeAg,. there was no significant difference between the detection rate of HBV-DNA and LHBs （ P 〉 0. 05 ） ; the detection rate of PreSlwas lower than that of HBV-DNA（ P 〈 0. 05 ） ,the detection rate of PreS2 was higher than that of HBV-DNA （ P 〈 0. 05 ）. There was a positive relationship between the level of LHBs and the amount of HBV-DNA（ r = 0. 978,P 〈 0. 05 ）. Conclusions LHBs can reflect the replication of hepatitis B virus