乙型肝炎病毒外膜大蛋白和病毒标志物联合检测的意义

The combination detection and significance of HBV-LP and serum hepatitis B virus markers in HBV infected patients

目的探讨乙型肝炎病毒外膜大蛋白(HBV-LP)和乙型肝炎病毒(HBV)标志物联合检测的意义。方法应用酶联免疫吸附试验(ELISA)法检测196例HBV感染者血清中HBV-LP、应用实时荧光定量PCR法检测HBV-DNA以及时间分辨免疫荧光分析法定量检测乙型肝炎病毒标志物(HBV-M)。结果 196例HBV感染者血清中HBV-LP与HBV-DNA的阳性率差异无统计学意义(χ2=0.09,P>0.05);在HBV-DNA阳性患者中HBV-LP和乙型肝炎病毒e抗原(HBeAg)阳性率差异有统计学意义(χ2=68.76,P<0.05);HBV-DNA拷贝数的对数值与HBV-LP的吸光度值A有较好的相关性,其相关系数(r)=0.97(P<0.01,F=104.52);HBeAg阴性HBV感染者血清HBV-LP与HBV-DNA阳性率比较差异无统计学意义(χ2=0.74,P>0.05);不同HBV-M模式HBV感染者HBV-LP和HBV-DNA阳性率差异无统计学意义(P>0.05)。结论 HBV-LP能较准确地反映HBV复制水平,是HBV-M较好的补充;血清HBV-LP的含量与HBV-DNA的水平有较好的相关性;血清HBV-LP是监测HBV感染者体内病毒复制、疾病进展与疗效的较好指标;HBV-LP与HBV标志物联合检测更有助于HBV感染者的诊断和治疗。

Objective To explore the clinical significance of the combination detection of hepatitis B virus large protein（HBV-LP）and biomakers.Methods For 196 cases of infected serum,HBV-LP was measured by enzymelinked immunosorbent assay,serum HBV-DNA level was quantitatively detected by real-time polymerase chain reaction,and HBV-M was quantitatively detected by time resolved fluoroimmunoassay.Results The positive rates were not significantly different between HBV-LP and HBV-DNA（χ2=0.09,P0.05）.The positive rates were significantly different between HBV-LP and HBeAg in the HBV-DNA positive patients（χ2= 68.76,P0.05）.HBV-LP absorbance value was remarkablely correlated with the logarithm of HBV-DNA level,the correlate coefficient was 0.97（P0.01,F=104.52）.There was no significant difference between the positive rates of HBV-LP and HBV-DNA in the HBeAg negtive patient（χ2=0.74,P0.05）.The expressions were not significantly different between HBV-LP and HBV-DNA in various patterns of HBV serological markers either（P0.05）.Conclusion Serum HBV-LP is laboratory marker that can accurately reflect HBV-DNA reproduction,and was helpful for complementarity of HBV-M.There is a good correlation between the expression of HBV-LP and the level of HBV-DNA.HBV-LP is valuable for monitoring HBV-DNA replication therapeutic effect and progression of the disease,the combination with the HBV-M can help to the diagnose and treat HBV infected.