HBeAg阴性乙型肝炎患者前S1、前C区变异、HBV DNA载量的相关性研究

Analysis of the relationship of serum PreS1、HBV-DNA and mutation frequency of Pre C in HBV infection patients with negative HBeAg

目的 探讨HBeAg阴性的乙型肝炎（HBV）感染者前S1抗原阳性与前C区变异发生频率、HBV DNA阳性率之间的关系.方法 用荧光定量PCR检测313例HBeAg阴性HBV感染者血清HBV DNA载量,ELISA法检测前S1抗原,测序分析HBV前C区nt1 762～nt1 764位和 nt1 896位点基因突变.结果 313例血清HBV DNA阳性175例（55.6%）,阴性138（44.1%）;175例HBV DNA阳性的标本中有155例（88.6%）前S1抗原阳性,138例HBV DNA阴性的标本中前S1抗原阳性33例（23.9%）.HBV DNA与前S1抗原结果比较差异有统计学意义（P〈0.001）;总前S1抗原阳性188例,发生nt1 896位变异为160例,nt1 762～nt1 764位变异为117例.前S1抗原阴性的125例中,发生nt1 896位变异为67例,nt1 762～nt1 764位变异为69例.前S1抗原阳性与阴性患者nt 1 896位点变异率比较差异有统计学意义（P〈0.05）.结论 HBeAg阴性的HBV感染者中,前S1抗原不受前C区变异影响,可更客观地反映HBV复制状态.

Objective To Analysis of the relationship of serum PreS1,HBV DNA and mutation frequency of Pre C in HBV infection patients with negative HBeAg. Methods PreS1 and HBeAg were detected by ELISA,and HBV-DNA examined by fluorescence quantitative PCR,mutation of PreC nt1 762-nt1 764 and nt1896 were analysis by sequencing. Results Among 313 HBeAg （-）patients,the positive of HBV-DNA（＋）was 175（55.6%）,HBV-DNA（%）was 138（44.1%）. In 175 HBV DNA（＋）patients, 155 （88.6% ） patients PreS1 were positive and 33 （23.9 % ） PreS1 （＋） in 138 HBV-DNA（-） patients, the difference is significant（P〈0. 001） ;The total positive PreS1 Ag patients were 188,mutation in nt1 896 160 patients and 117 in nt1762-nt1 764,meanwhile,among 125 PreS（-）patients, mutation in nt1896 were 67 patients and 69 in nt1 762-nt1 764. The difference of frequency in ntl 896 mutation between positive and negative PreS1-Ag was statistically significant（P〈0.05）. Conclusion In the patients with HBeAg negative,PreS1-Ag is not affected by mutation of Pre C gene and affect the copy of HBV objectively.