乙型肝炎患者HBV-DNA载量与HBV血清标志物、前S1抗原的相关性

Relationship between HBV viral loads and serological markers,Pre-S1 antigen in patients of hepatitis B

目的探讨乙型肝炎患者HBV-DNA载量与血清标志物、前S1抗原的关系。方法对1384例乙型肝炎患者用荧光定量PCR法检测HBV-DNA,酶联免疫吸附试验(ELISA)检测HBV血清标志物和前S1抗原。结果HBV-DNA总检出率为64.8%,HBeAg阳性率为37.9%,前S1抗原阳性率为64.5%;HBeAg(+)者,其HBV-DNA检出率为95.4%,且定量对数值高,其阳性率明显高于HBeAg(-)组,差异有统计学意义(P<0.05);前S1抗原(+)组中HBV-DNA阳性率比前S1抗原(-)组高,其差异有统计学意义(P<0.05);随着HBV-DNA定量对数值的增高,大三阳的检出率具有逐渐增加的趋势;当HBV-DNA≥105时,转氨酶异常的检出率显著增加。结论HBV-DNA与HBeAg高度相关,均为评价乙型肝炎病程及病毒复制的良好指标。联合检测HBV血清标志物、前S1抗原及HBV-DNA的含量,对准确了解患者感染状态具有重要的临床应用价值。前S1抗原可作为HBeAg阴性、无条件开展HBV-DNA检测时的补充指标。

Objective To investigate the relationship between HBV viral loads and serological markers, pre-S1 antigen in patients of hepatitis B. Methods HBV-DNA was detected by Fluorescent Quantitative PCR （FQ-PCR）. Serological markers, pre-S1 antigen of hepatitis B virus were detected by ELISA in 1386 patients of hepatitis B. Results The detection rate of HBV-DNA was 64.8%. The positive rate of HBeAg and pre-S1 antigen was 37. 9%,64. 5% respectively. The detection rate of HBV-DNA in HBeAg-positive patients was significantly higher than that in HBeAg-negative patients （P〈0.05）, and the level of HBV-DNA was higher too. The detection rate of HBV-DNA in pre-S1 antigen positive patients was significantly higher than that in pre-S1 antigennegative patients （P〈0.05）.With the level of HBV-DNA,the detection rates of HBeAg increased. When the level of HBV-DNA was greater than or equal to 10^5 ,the detection rate of transaminase would significantly increase. Conelusion HBV-DNA displays a positive correlation with HBeAg,and both of them can be used as reference indicators for assessment of level of replication of HBV and the progress of the chronic hepatitis B. It is significant that detection of HBV serological markers and preS1 antigen along with HBV-DNA may help assess the status of viral replication. PreS1 antigen may serve as an auxiliary indicator in HBeAg-negative eases or when HBV-DNA detection is impossible.