乙型肝炎病毒核酸抗原相关的检测及临床意义

The detection and clinical significance of hepatitis B virus nucleic acids associated antigens

目的评价乙型肝炎病毒核酸相关抗原(HBV NRAg)在乙肝诊疗中的价值。方法 FQ-PCR、ELISA测定378例乙肝患者HBV含量、五项血清标志物、HBV NRAg,采用巢式PCR对乙肝患者进行确认,并检测300例健康人群HBV NRAg作为对照。结果 HBV NRAg灵敏度、特异性分别为91.3%、99.7%;与巢式PCR比较,HBV NRAg阳性和总符合率均显著高于FQ-PCR、HBeAg(P=0.00)。HBsAg-隐匿性乙肝组,HBV NRAg阳性检出率为60%。乙肝患者抗病毒治疗的监测表明,HBV NRAgS/CO值与HBV含量动态变化趋势基本一致。结论 HBV NRAg作为HBV感染血清标志物的一个新的补充,在乙肝临床诊断、献血员筛选、病情判断及治疗监测均有很高的临床价值。

Objective To evaluate the clinical significance of hepatitis B virus nucleic acids associated antigens （HBV NRAg） in the diagnosis and treatment of hepatitis B. Methods HBV loads, five serologic markers and HBV NRAg were detected in 378 cases using fluorescent quantitative PCR, ELISA methods. Hepatitis B patients were confirmed by nested PCR and HBV NRAg in 300 healthy individuals were detected as control. Results Sen- sitivity and specificity of HBV NRAg were 91.3%, and 99.7% respectively. Compared with nested PCR, the posi- tive and total concordant rate of HBV NRAg were significantly higher than the FQ-PCR, HBeAg （P=0. 00）. The positive rate of HBV NRAg in occult hepatitis B patients with HBsAg negative was 60%. Monitoring on antiviral therapy of hepatitis B showed that HBV NRAg S/CO values were consistent with HBV dynamic changes. Conclu- sion HBV NRAg, as a new serological marker of HBV infection, is significant in hepatitis B clinical diagnosis, blood donors sieving, and treatment monitoring.