乙型肝炎病毒外膜大蛋白的检测及其临床意义

Detection and Clinical Significance of Hepatitis B Virus Large Surface Protein

目的探讨乙型肝炎病毒外膜大蛋白(HBV-LP)与乙型肝炎病毒脱氧核糖核酸(HBV-DNA)的相关性,及其检测对诊断乙型肝炎病毒复制的临床意义。方法采用酶联免疫吸附试验(ELISA)和实时荧光定量聚合酶链反应(FQ-PCR)技术对180例HBsAg阳性血清标本进行HBV-LP和HBV-DNA的平行检测。结果在乙型肝炎病毒感染者血清中,HBV LP含量与HBV-DNA拷贝数间具有良好的正相关性(r=0.85,P<0.001);不同HBV-DNA拷贝数组别间HBV-LP含量差异具有统计学意义(P<0.01);在180例HBeAg阳性标本中,HBV-DNA阳性率为79.4%,HBV-LP的阳性率为83.9%,二者差异无统计学意义(P>0.05);在90例HBeAg阳性标本中,HBV-DNA、HBV-LP阳性率分别为94.4%(85/90)、95.6%(86/90),二者差异无统计学意义(P>0.05);在90例HBeAg阴性标本中,HBV-DNA与HBV-LP的阳性检出率分别为41.1%(37/90)、77.8%(70/90),差异具有统计学意义(P<0.01)。结论 HBV-LP是判断乙型肝炎病毒感染者体内病毒复制程度的可靠指标,尤其是HBeAg阴性患者体内病毒复制及预后判断良好的血清学检测指标。

Objective To explore the clinical significance and the relationship between hepatitis B virus large surface protein and HBV DNA in the diagnosis of viral replication. Methods Enzyme linked immunosorbent assay（ELISA）methods were used to examine the HBVLP and quantitative real time PCR methods were used to detect the HBV DNA of 180 HBsAg-positive serum samples. Results The contents of serum HBV-LP was positively correlated with HBV-DNA copies（r=0.85,P〈0. 001）. The level of serum HBV-LP was also significantly different between the groups with different HBV-DNA copies（P〈0.01）. No significant difference of positive rate was observed between HBV DNA 79.4%（143/180）and HBV LP 83.8%（151/180）（P〉0. 05）in 180 HBsAg-positive serum samples. Postive rate of HBV DNA and HBV LP were 95.0% （85/90）and 96.0%（86/90）in 90 HBeAg- postive samples and were 41.8%（37/90）and 77.5%（70/90）in 90 HBeAg-negative samples（P〉0.05）. Conclusion HBV-LP may serve as a reliable marker in the reflection of HBV replication at protein level,and it is valuable to monitor HBV replication and prognosis of the disease,especially in HBeAg negative HBV infected patients.