乙肝表面抗原大蛋白检测的临床意义

Clinical Significance of Detection Large Hepatitis B Surface Protein

目的探讨乙肝表面大蛋白（large HBV surface protein，LHBs）在慢性乙肝患者中检测的临床价值。方法收集2011年6月～9月期间武汉大学人民医院220例慢性乙肝患者的血液标本，同时检测血清LHBs，Pre—S1，HBsAg以及血浆HB、LDNA，并对各指标进行比较。结果220例慢性乙肝患者中，HBsAg检测结果阳性率为100％，HBV-DNA阳性率为64．5％，LHBs和Pre-S1阳性率分别为82．7％和76．4％，其一致性为90．0%；LHBs阳性率明显高于Pre-S1（χ^2=7．68，P〈0．05）；HBV-DNA阳性患者中LHBs和PreS1阳性率分别为97．4％和89．7％，一致性为92．3％，LHBs阳性率明显高于Pre-S1（χ^2=4．17，P〈0．05）；HBV-DNA阴性患者中LHBs和PreS1阳性率分别为74．6％和69．0％，一致性为88．7％，其阳性率差异无统计学意义（r=3．06，P〉0．05）。结论LHBs与Pre-S1均是较好的HBV感染治疗监测指标，LHBs性能优于Pre-S1，可能替代HBV-DNA和Pre-S1作为慢性乙肝治疗监测的指标。

Objective To explore the value of detecting large hepatitis B surface protein, （LHBs） in chronic hepatitis B （CHB） patients. Methods Collected blood samples of 220 CHB patients from June to July 2011 in Renmin Hspital of Wuhan University, detected and compared the serum LHBs,Pre-S1, HBsAg and plasma HBV-DNA. Results Of all the 220 CHB patients,the positive rate of HBsAg was 100%,the positive rate of HBV-DNA was 64. 5 %,the positive of LHBs and Pre-S1 was 82.7% and 76.4% ,respectivly. The concordance rate was 90% ,and the positive rate of LHBs was distinct high er than Pre-S1（χ^2=7.68,P〈0. 05）. The positive of LHBs and Pre-S1 was 9？. 4% and 89. 7%, in HBV-DNA positive CHB patients, respectivly. The concordance rate was 92.3 %, and the positive rate of LHBs was distincthigher than Pre-S1 （χ^2 = 4.17, P〈0.05）. The positive of LHBs and Pre-S1 was 74.6 % and 69.07 % in HBV-DNA negative CHB patients, respectivly. The concordance rate was 88. 7%, and there was no significant difference between the positive rate （χ^2 = 3. 06, P〈 0.05）. Conclusion LHBs and Pre-S1 are both good index for monitoring of therapy in CHB, hut LHBs maybe better,and LHBs maybe a good substitute for HBV-DNA and Pre-S1 in monitoring CHB treatment.