血清乙肝病毒外膜大蛋白的检测及其与病毒复制关系初探

Detection of hepatitis B virus large protein in serum and investigation of its relationship with virus replication

目的:探讨乙肝病毒外膜大蛋白与HBV-DNA、HBeAg之间的关系及在判断病毒复制中的临床应用价值。方法:分别采用ELISA法检测HBV-LP、HBeAg,实时荧光定量PCR法检测HBV-DNA,并且分析比较三者之间的阳性率及相关性。结果:在222例慢性乙肝患者中,HBV-DNA的拷贝数与HBV-LP的吸光度值具有良好的正相关性(r=0.640,P<0.05);HBV-DNA的阳性率为74.8%,HBV-LP的阳性率为86.0%,HBeAg的阳性率为41.4%;三者之间的阳性率比较有显著性差异(P<0.05),阳性率HBV-LP>HBV-DNA>HBeAg;在166例HBV-DNA阳性的慢性乙肝患者中,HBV-LP的阳性率为91.6%,HBeAg的阳性率为54.2%,两者比较有显著性差异(P<0.05);在92例HBeAg阳性的慢性乙肝患者中,HBV-LP的阳性率与HBV-DNA比较无显著性差异(P>0.05),但在130例HBeAg阴性的慢性乙肝患者中,HBV-LP的阳性率与HBV-DNA比较有显著性差异(P<0.05),前者阳性率高于后者。结论:作为乙肝病毒在体内的复制指标,HBV-LP在血清学水平能更准确可靠的反映其在体内的复制情况,特别是在HBeAg阴性的慢性乙肝患者中能更准确敏感的反映体内病毒复制情况,值得推广使用。

Objective：To explore the relationship among large protein（HBV-LP）,deoxyribonucleic acid（HBV-DNA） and E antigen（HBeAg） of hepatitis B virus and evaluate their clinical application.Methods：The HBV-LP and HBeAg were detected by ELISA and the HBV-DNA was assayed by real-time quantitative polymerase chain reation（RT-PCR）.The positive rate of them and their relation were also studied.Results：Of 222 chronic hepatitis B patients,the copies of HBV-DNA was related positively to the absorbency HBV-LP（r=0.640,P0.05）;the positive rate of HBV-DNA,HBV-LP and HBeAg was 74.8%,86.0%and 41.4%,individually.Of 166 chronic Hepatitis B patients with negative HBV-DNA,the positive rate of HBV-LP and HBeAg was 91.6% and 54.2%,individually,and significant difference was found（P0.05）.Of 92 patients with HBeAg.The positive rate of HBV-LP was not significantly difference with that of HBV-DNA（P0.05）,however,of 130 patients without HBeAg,the positive rate of HBV-LP was significantly higher than that of HBV-DNA（P0.05）.Conclusion：As an evidence of replication of HBV in vivo,HBV-LP shows more exactly than HBV-DNA,especially in chronic hepatitis B patients without HBeAg.