慢性乙型肝炎病毒感染者血清乙型肝炎病毒核酸相关抗原检测的应用价值

Chronic hepatitis B virus infection of hepatitis B virus associated antigen nucleic acid detection value of clinical application

目的探讨慢性乙型肝炎病毒(HBV)感染者血清乙型肝炎病毒核酸相关抗原(HBV NR Ag)检测的临床应用价值。方法选择慢性HBV感染者292例,男性158例,女性134例,空腹采集静脉血。采用酶联免疫吸附试验(ELISA)检测受试者血清HBV NR Ag及前S1抗原(PreS1Ag);化学发光法检测乙型肝炎标志物[HBV表面抗原(HBsAg)、HBV表面抗体(HBsAb)、HBVe抗原(HBeAg)、HBVe抗体(HBeAb)、HBV核心抗体(HBcAb)]含量;实时荧光定量聚合酶链反应(PCR)技术检测HBV-DNA含量;检测患者肝功能指标[丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBIL)、总蛋白(TP)、白蛋白(Alb)]。结果 292例慢性HBV感染者中,HBV-DNA阳性患者181例。HBV-DNA阳性患者中HBV NR Ag、HBeAg、PreS1Ag阳性率分别为96.7%、45.3%、73.5%。无论HBeAg和HBeAb是否阳性,HBV DNA与HBV NR Ag阳性率差异均无统计学意义(P均>0.05)。HBV NR Ag的表达与HBV-DNA拷贝数呈正相关(r=0.915 5,P<0.05)。HBV NR Ag阳性患者的ALT、AST水平明显高于HBV NR Ag阴性患者(P<0.05)。结论HBV NR Ag与病毒复制有关,与HBV-DNA水平高度相关,并参与对肝细胞的损伤,是监测HBV复制和抗病毒疗效的一种新指标。

Objective To explore chronic hepatitis B virus （HBV） infected serum hepatitis B virus nucleic acid related antigen （HBV NR Ag） testing in the clinical application value. Methods Selection of chronic HBV infection in 292 cases （male 158 cases, female 134 cases）, fasting venous blood was collected. Using enzyme-linked immuno-sorbent assay （ELISA） to detect serum antigen of HBV nucleic acid related subjects and former S1 antigen （PreStAg）; Chemiluminescence method to detect HBV marker （HBsAg, HBsAb, HBeAg, HBeAb, HBcAb） content; Real-time fluorescent quantitative PCR technique to detect the contents of HBV-DNA; The Hitachi 7600 bio-chemical analyzer test in patients with liver function index [ alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, total bilirubin （TBIL）, total protein （TP）, albumin （propagated）], the results for statistical analysis. Results Two hundrend and ninety- two cases of chronic HBV infection, HBV NR Ag, HBeAg, PreS1Ag and HBVDNA positive patients with positive coin- cidence rate was 96.7%, 45.3%, 73.5%. Regardless of the pattern of HBeAg, HBeAb and HBV DNA （＋） patients NRAg positive rate had no statistical difference （P〉0.05）. The expression of HBV NR A.g was positively associated with HBV- DNA eopy number （r=0.915 5, P〈0.05 ）, HBeAg and PreS1Ag results with HBV DNA had significant statistical difference （P〈0.01）. ALT, AST levels of HBV NR Ag positive patients was obviously higher than that of HBV NR Ag negative patients （P〈O.05）. Conclusion HBV NR Ag associated with virus replication, and highly related to the level of HBV- DNA and participate in the injury of liver cells, is monitoring HBV replication and antiviral effect of a new indicator.