乙型肝炎病毒前S1蛋白的检测及临床意义

The detection and significance of HBV Pre S1 protein

目的分析前S1(Pre-S1)蛋白在诊断慢性乙型肝炎病毒复制及肝脏炎症及纤维化程度中的作用。方法收集慢性乙型肝炎患者103例,均经肝活组织检查证实。检测其Pre-S1蛋白,HBV标志物与HBV DNA,按病理学将肝组织炎症分为G1、G2、G3、G4级,纤维化程度分为S1、S2、S3、S4期。结果以HBV DNA定量>103拷贝/毫升为诊断标准,Pre-S1蛋白与HBV DNA的符合率为88.1%;在肝组织不同炎症程度G1、G2、G3、G4级,HBV DNA与Pre-S1蛋白的符合率分别为88.1%、96.3%、92.9%、83.3%;在不同肝纤维化程度S1、S2、S3、S4期,符合率分别为84.2%、91.7%、90.9%、75.0%。结论Pre-S1蛋白对HBV复制的情况其检测灵敏性(与HBV DNA的相关性)和检测有效率都优于HBeAg检测;Pre-S1蛋白对肝脏炎症及纤维化程度的判断有较好的临床价值。

Objective To determine the role of Pre-S1 protein in diagnosing viral replication,hepatic inflammation and fibrosis in patients with chronic hepatitis B.Methods 103 consecutive patients with chronic hepatitis B were included in the study,and liver biopsies were performed in all patients.Serial serum samples were studied with the quantitative determination of HBV DNA by a quantitative PCR assay,and determination of Pre-S1 protein by ELISA.The degrees of hepatic inflammation were divided into G1,G2,G3,G4,and degrees of hepatic fibrosis were divided into S1,S2,S3,S4.Results HBV DNA103copies/ml as positive criteria for diagnosing viral replication.The rate between Pre-S1 protein and HBV DNA detection was 88.1%;The rates between Pre-S1 protein and HBV DNA detection were 88.1%,96.3%,92.9%,83.3% in G1,G2,G3,G4 grading;The rates between Pre-S1 protein and HBV DNA detection were 84.2%,91.7%,90.9%,75.0% in S1,S2,S3,S4 staging.Conclusion The efficiency and sensitivity of Pre-S1 test were higher than of HBeAg,more sensitive than HBeAg test in diagnosing viral replication in patients with chronic hepatitis B.And Pre-S1 protein as a good sign in diagnosing degrees of of hepatic inflammation and fibrosis.