对乙型肝炎患者检测乙肝表面抗原大蛋白和前S1抗原的区别和临床意义

Clinical significance of hepatitis B virus large surface protein

[目的]检测乙肝患者血清中乙肝表面抗原大蛋白（Hepatitis B Virus Large Surface Protein,LHBs）、乙肝前S1、HBV DNA,探讨LHBs用于乙肝患者临床诊断的意义。[方法]采用酶联免疫吸附实验（ELISA）检测LHBs以及乙肝前S1,采用化学发光方法检测乙肝两对半,采用荧光定量PCR方法对患者HBV DNA进行检测。[结果]（1）相同乙肝模式患者血清LHBs与HBV DNA检出率比较差异无显著性意义（P〉0.05）;（2）HBeAg阳性患者血清中LHBs与HBV DNA阳性率均明显高于HBeAg阴性患者,差异有显著性意义（P〈0.05）;（3）相同乙肝模式患者血清乙肝前S1的检出低于HBV DNA的检出,两者相比较差异有显著性意义（P〈0.05）。[结论]LHBs可以弥补由于乙肝病毒变异引起的HBeAg检测的不足,LHBs可以反映病毒复制。

[Objective] To explore the clinical significance of HBV large protein（LHBs） in diagnosing viral replication,we detected the LHBs,HBV,DNA,HBV preS1 and the hepatitis B viral markers（HBV M） in the serum of the patients infected with HBV.[Methods] LHBs,HBV preS1 and HBV M were analyzed by ELISA.HBV DNA was quantitatively detected using real-time detection polymerase.[Results]（1） No significant difference between the detectable rate of HBV DNA and LHBs was found in the same HBV M（P0.05）.（2） The positive rates of LHBs and HBV DNA in HBeAg positive patients were higher than that of HBeAg negative patients（P0.05）.（3） There was significant difference between the detectable rate of HBV DNA and HBV preS1 was found in the same HBV M（P0.05）.[Conclusion]There is a perfect correlation between the positive rate of LHBs and HBV DNA,and LHBs is a reliable serological marker that can reflect the replication of HBV.The average value in LHBs positive patients was higher than that of LHBs negative patients.The result shows that LHBs can reflect liver function.