乙型病毒性肝炎不同血清学模式前S1抗原、乙型肝炎病毒-DNA和肝功能指标的关系

Clinical significance of detecting the serum pre-S1 antigen and HBV-DNA in patients with heptatitis B virus

目的检测乙型肝炎病毒(HBV)感染者不同血清学模式前S1抗原(pre-S1-Ag)、HBV-DNA和乙型肝炎抗原、抗体含量,结合血清肝功能(丙氨酸转氨酶ALT、天冬氨酸转氨酶AST)分析病毒性肝炎临床诊断、病情判断和预后。方法用酶联免疫吸附试验(ELISA)检测94例HBV感染者血清中pre-S1-Ag和乙型肝炎抗原、抗体,用荧光定量-聚合酶联反应(FQ-PCR)方法检测HBV-DNA含量,用全自动生化分析仪检测血清ALT和AST指标。结果HBsAg(+)、HBeAg(+)、HBcAb(+)模式的pre-S1-Ag检出率为79.4%,HBV-DNA检出率为97.1%,肝功能异常的为94.1%;HBsAg(+)、HBeAb(+)、HBcAb(+)模式的Pre-S1-Ag检出率为52.4%,HBV-DNA检出率为83.3%,肝功能异常的为88.1%;在HBsAg(+)和HBcAb(+)模式中pre-S1-Ag检出率为33.3%,HBV-DNA检出率为66.7%,肝功能异常的为33.3%。结论HBV-DNA检测在反映乙型肝炎病毒复制情况的检出率明显高于HBV pre-S1-Ag,但是HBV pre-S1-Ag检测成本低廉,与HBV-DNA的符合度较高,是对乙型肝炎"两对半"和HBV-DNA测定的重要补充和加强。乙型肝炎抗原、抗体及HBV-DNA联合pre-S1-Ag检测可以提高HBV的检出率,更能真实地反映出HBV在体内的复制情况,为乙型肝炎患者的诊断、治疗和预后判断提供依据。

Objective To study the clinical significance of detecting the HBV pre-S1- Ag, HBV-DAN Particles in patient infected with HBV. We combined the detection of hepatic function to analyze the clinical diagnosis, pathogenetic condition and prognosis of patients with HBV. Methods The HBV markers.pre-S1 Ag and the HBV-DAN Particles were detected by ELISA in 94 patients with hepatitis B virus. Results The positive detection rates for pre-S1 antigen and HBV-DAN in the HBsAg （ ＋ ） ＋ HBeAg （ ＋ ） ＋ HBcAb （ ＋ ） model were 79.4% and 97.1%, respectively the rate of dysfunction of liver was 94.1%. In the HBsAg（＋） ＋ HBeAb（＋） ＋ HBcAb（ ＋ ） model, the positive detection rates for pre-S1 antigen and HBV-DAN Particles were 52.4% and 83.3% respectively and the rate of dysfunction of liver was 88.1% separately. There was a lower positive rate of HBV-DAN and pre- S1-Ag in the HBsAg （＋） ＋ HBcAg （ ＋ ） model. Conclusion The detection of HBV-DAN Particles is the most sensitive and specific method reflecting the replication of hepatitis B virus in clinical work. Pre-S1-Ag detection for hepatitis B virus can be used as a supplement to hepatitis B markers and HBV-DAN detection.