HBV前S1抗原与HBV DNA联合检测的临床意义

The Clinical Significance of Detection of HBV Pre-Sl Combination with HBV DNA in Patients with Hepatitis B Virus Infection

目的探讨乙型肝炎病毒前S1抗原(HBV pre-Sl)、HBV DNA与HBV表面标志物(HBV-M)的关系。方法从临床乙型肝炎标本中筛出HBsAg阳性病例329例,采用ELISA法检测乙肝血清标志物和前S1抗原,荧光定量PCR法检测标本HBV DNA。结果血清HBeAg抗原阳性组,HBV DNA和pre-Sl的阳性率分别为97.2%和90.0%,而HBeAg抗原阴性组的HBV DNA与pre-Sl阳性率分别为42.9%和37.0%,HBeAg阳性患者血清的HBV DNA与pre-Sl的阳性检出率明显高于HBeAg阴性患者。结论 HBV pre-Sl和HBV DNA在各组中阳性检出率有较高的一致性,pre-Sl在一定程度上可替代HBV DNA。pre-Sl与乙肝血清标志物联合检测能为乙肝患者病毒复制、肝功能损伤提供有价值的实验室依据,同时有助于慢性乙肝患者疗效考核和预后判断。

Objective To study the correlations between pre-Sl antigen,HBV DNA,hepatitis B virus（HBV） serum markers in patients with chronic hepatitis B.Methods The HBV markers,pre-Sl antigen and HBV DNA were determined using enzyme-linked immunosorbent assay and quantitative PCR in 329 patients with chronic hepatitis B.Results The positive rates of serum HBV DNA and pre-Sl-antigen were 97.2% and 90.0% respectively in HBeAg-positive patients.The positive rates of HBV DNA and pre-Sl-antigen were 42.9% and 37.0% respectively in HBeAg-negative patients.The positive rates of HBV DNA and pre-Sl-antigen were significantly higher in HBeAg-positive patients than in HBeAg-negative patients.Conclusions The positive rate of pre-Sl antigen and virus loads of HBV have higher consistency in all groups,thus serum pre-Sl antigen can substitute HBV FQ-PCR to some extent.Detection of HBV serum pre-Sl antigen,along with HBV serum immunological marker may help assess the status of viral replication and liver injury situation,and valuable diagnostic evidence in patients with chronic hepatitis B.They also may serve as an auxiliary indicator for therapeutic efficant and prognosis.