摘要
目的探讨乙型肝炎病毒抗HBCIgM、前S1抗原（HBVPreS1—Ag）与HBV—DNA的相关性。方法从临床检测HBV—M的标本中筛出HBV阳性病例203例，采用ELiSA法检测抗HBcIgM、HBVPreS1Ag和荧光定量PCg法检测标本HBV-DNA，并与5例HBV～M全阴性血清进行比较，同时采用酶法检测所有血清标本的ALT和AST。结果抗HBcIgM、H8VPre—S1Ag和HBV-DNA在HBeAg（＋）组中检出率分别为756％、90．2％和100％，在HBsAg（＋）＋HBeAb（＋）＋HBcAb（＋）组中检出率为589％、42．5％和481％。在HBsAg（＋）＋HBcAb（＋）、HBsAg（＋）、HBeAb＋HBcAb三组中，抗HBcIgM、HBV～DNA和HBVPre-S1Ag仍有一定检出率。抗HBc-IgM（＋）组中．ALT和AST异常率分别占74．3％和65．8％HBVPre-S1Ag（＋）组中，ALT和AST异常率分别占543％和467％。结论抗HBcIgM是乙型病毒性肝炎早期诊断和监测慢性肝炎急性发作的重要指标，HBV—DNA阳性检出率通常被当作HBV感染及复制的金标准，HBV低廉，指示急性乙型肝炎向慢性转变。评估Pre—S1Ag与HBV—DNA的符合率较高，是对HBV—M和HBV—DNA测定的重要补充和加强，在没有条件开展HBV—DNA定量的广大基层医院．进行HBV—M检测时，抗HBcIgM和HBVPre—s1Ag联合检测，互补共存，可以更好地服备于临床．
Objective To study the relationship of the Anti-HBc-IgM. HBV Pre-sAg. HBV-DNA. HBV-M and hepatic enzyme in patient infected with HBV.Methods The serum Anti-HBc-lgM. Pre-s1 antige and HBV-DNA were tested by ELISA and real-time fluorescent quantitative PCR（RT-PCR） in 203 patients infected with HBV screening HBVM by ELISA method .At the mean time . and 5 HBV-M negative samples were tested.ALT and AST were tested by rate method in all samples. Results the positive rates of the Anti-HBc-IgM.the Pre-S1Ag.and HBV-DNA were 73. 6%.90.2% and 100% separately.The positive detection rates for the Anti-HBc-IgM. pre-S1Ag and HBV-DNA in the HbsAg（＋）＋HbeAb（＋）HbcAb（＋） model were 38.9%. 42.5% and 48.1% separately.There still had a little positive rate of the Anti-HBc-IgM. Pre-S1Ag and HBVDNA in the HbsAg（＋）＋HbcAb（＋） model .HbsAg（＋） model and HbeAb＋HbcAb model.The abnormal rate of ALT and AST in the Anti-HBc-IgM＇ s postive model were higher than that in Anti- HBc-IgM＇ s negative model （ALT 74.3% and 31.7%,AST65.8% and 30. 1%）.The abnormal rate of ALT and AST in the pre-S1Ag＇ s postive model were higher than that in pre-slAg＇ s negative model （ALT 54.3% and 0,AST46.7% and 0）. Conclusion .Anti-HBclgM is an important indicator of the early diagnosis and monitoring of hepatitis B virus acute exacerbation of chronic hepatitis, HBV-DNA positive rate of HBV is generally regarded as the gold standard for the infection and replication , Pre-S1Ag and HBV-DNA is a line with a higher rate .It can be used as an important complement and strengthen of the hepatitis B markers and HBV-DNA. In the absence of conditions to carry out the vast number of HBV-DNA quantitative primary hospital. Anti-HBclgM and HBVPre-S1Ag joint detection For HBV-M Complementary co-existence,we can better serve the clinical.
