乙肝病毒外膜大蛋白检测在病毒复制判定中的意义

Significance of hepatitis B virus large envelope protein detection in estimation the replication and activity of HBV

目的探讨血清乙型肝炎病毒外膜大蛋白(LHBs)检测在乙型肝炎病毒复制判定中的意义。方法225例HBV感染者,采用实时荧光定量PCR法检测血清中HBV DNA拷贝数,ELISA法检测HBsAg、HBeAg、HBVPreS1Ag、HB-VPreS2Ag、LHBs,全自动速率法测定ALT、AST,制作受试者工作特性曲线(ROC)并进行相关性分析。结果LHBs、HBeAg、PreS1-Ag、PreS2-Ag与HBV DNA的阳性符合率分别为92.49%、58.96%、78.03%与79.19%,LHBs结果与HBVD-NA无统计学差异(P=0.099),HBeAg、PreS1-Ag、PreS2-Ag结果与HBVDNA有明显的统计学差异(P<0.01)。LHBs水平与HBV DNA拷贝数对数值呈正相关(r=0.852,P=0.022)。用LHBs水平判断HBV是否存在复制的ROC曲线,其曲线下面积为0.911。LHBs阳性患者的ALT、AST水平明显高于LHBs阴性患者。结论乙型肝炎病毒外膜大蛋白与HBV DNA有较高的符合率,可反映乙肝患者体内病毒复制和活动情况。

Objective To explore the clinical sigificance of hepatitis B virus large envelope protein（LHBs） in diagnosing HBV replication in hepatitis B patient. Methods Serum HBV DNA was quantitively detected by using real-time polymerase chain reaction （RT-PCR）, The HBsAg, HBeAg, HBVPreS1Ag, HBVPreS2Ag and LHBs were measured by enzyme linked immunosorbent assay （EHSA） and ALT, AST were measured by automatic chemistry analyzer in 225 serum samples collected from hepatitis B patients. Results The positive rates of LHBs, HBeAg, HBVPreS1Ag and HBVPreS2Ag accord with HBV DNA were 92.49 %, 58.96%, 78.03 % and 79.19%, respectively. No significant difference was found in the positive rate between LHBs and the levels of HBV DNA （P = 0.099） and there was a positive correlation between quantitations of HBV DNA and LHBs（ r = 0. 852, P = 0. 022）. The aera under the curve of ROC was 0.911 .The average level of ALT and AST in LHBs positive patient was high than that of LHBs negative ones. Conclusion There is a perfect correlation between the positive rate of LHBs and HBV DNA, and LHBs is a reliable serological marker that can reflect the replication and activity of HBV.