妊娠期乙型肝炎病毒感染者前S1抗原检测临床意义分析

Clinical significance of Pre-S1 antigen detection for gestational HBV infection

目的探讨乙型肝炎病毒(HBV)前S1抗原(Pre-S1)检测对于妊娠期HBV感染者的临床意义。方法对120例妊娠期乙型肝炎(简称乙肝)患者血清标本用酶联免疫吸附法检测Pre-S1、时间分辨荧光免疫分析法检测乙肝五项指标、荧光定量聚合酶链反应检测HBVDNA,并对测定结果进行统计学分析。结果 120例血清标本中共检测出乙肝五项大三阳35例,小三阳44例,其他HBsAg阳性模式41例。大三阳组Pre-S1、HBVDNA阳性率分别为91.4%、85.7%,高于其他各组(P<0.05);小三阳组Pre-S1、HBVDNA阳性率分别为68.2%、59.1%,高于其他HBsAg阳性组(P<0.05);其他HBsAg阳性组Pre-S1、HBVDNA阳性率为34.1%和19.5%。结论妊娠期妇女血清Pre-S1水平与HBVDNA、HBeAg密切相关,可用于判断HBV复制和传染性,对于预防HBV宫内感染、联合阻断产前及产后HBV母婴传播有重要意义。

Objective To investigate the clinical significance of pre-S1 antigen（Pre-S1） detection for gestational hepatitis B virus（HBV） infection.Methods Enzyme linked immunosorbent assay,time resolved fluoro-immunoassay and fluorescent quantitation polymerase chain reaction were performed for the detection of Pre-S1,serum markers of HBV and HBV DNA respectively in 120 cases of patients with gestational HBV infection,and the results were statistically analyzed.Results In total 120 cases,35 cases were positive with HBsAg,HBeAg and HBcAb（Group A）,44 cases were positive with HBsAg,HBeAb and HBcAb（Group B） and 41 cases were positive with HBsAg for other models（Group C）.In group A,the positive rates of Pre-S1 and HBV DNA were 91.4% and 87.7%,higher than other groups（P0.05）,in group B were 68.1% and 59.1%,higher than Group C（P0.05）,and in Group C were 34.1% and 19.5%.Conclusion Serum level of Pre-S1 was correlated with HBV DNA and HBeAg in pregnant woman,which could serve for the judgment of HBV replication and infectivity,with significant value for preventing intrauterine infection and antepartum and postpartum transmission.