乙型肝炎病毒前S1抗原与相关血清标志物联合检测的临床价值探讨

Investigation of the clinical significance by detecting both the hepatitis B virus Pre-S1 antigen and the related serum markers

目的探讨乙型肝炎病毒(HBV)前S1抗原在感染者不同模式血清标志物(HBV-M)中的阳性表达情况,评价其临床应用价值。方法采用酶联免疫吸附试验(ELISA)法检测386例乙型肝炎(下称乙肝)病毒表面抗原(HBsAg)阳性血清标本的乙肝病毒前S1抗原和HBsAg、抗-HBs、乙肝病毒e抗原(HBeAg)、抗-HBe、抗-HBc,并对检测结果进行比较分析。结果前S1抗原在HBsAg阳性、HBeAg阳性、抗-HBc阳性和HBsAg阳性、HBeAg阳性组的阳性率显著增高,分别为87.1%和84.6%;在HBsAg阳性、抗-HBc阳性、和HBsAg阳性、抗-HBe阳性、抗-HBc阳性以及HBsAg阳性组前S1抗原的阳性率依次为60.0%、49.8%和33.3%;HBeAg阳性组的前S1抗原阳性率86.7%,明显高于HBeAg阴性组51.0%(P<0.01);386例乙型肝炎病毒感染者中,前S1抗原阳性率为60.1%,HBeAg阳性率为25.4%,两者差异有统计学意义(P<0.01)。结论前S1抗原作为HBV感染、复制的指标较HBeAg更敏感,可补充和完善乙肝五项检测的不足,尤其对HBeAg阴性的血清,检测前S1抗原,能更好地反映病毒的复制状态和传染性,同时对病情的预后和疗效的判断也有一定的指导意义。

Objective To investigate the positive rate of pre S1 antigen in different models of serum HBV markers（HBV-M） in the serums of patients with hepatitis B virus and appraise its clinical significance. Methods ELISA method was used to detect the hepatitis 13 virus pre-S1 antigen, HBsAg, HBsAb, HBeAg, HBeAb and HBcAb in the serums from 386 samples of patients with hepatitis. The detected results were analyzed comparatively. Results Pre-S1 positive rate was 87.1% in the group with HBsAg positive, HBeAg positive and anti-HBcAb positive; 84. 6% in the group with HBsAg positive and HBeAg positive; 60% in the group with HBsAg positive and anti-HBc positive; 49.8% in the group with HBsAg positive,anti-HBe positive and anti-HBc positive; 60. 1% in the group with H13sAg positive. The positive rate of pre-S1 antigen of group with HBeAg positive was 86.7% and it was significantly higher than that of group with HBeAg negative which was 51.0 % （P〈0.01）. In the 386 samples of hepatitis 13 virus infection,the positive rate of pre-S1 antigen was 60.1% and the HBeAg positive rate was 25.4%. So the difference was statistically significant（P〈0.01）. Conclusion As an index of infection and reproduction of HBV,pre- S1 antigen is much more sensitive than HBeAg and has the supplemental significance for the inspection of HBV-M.