乙型肝炎病毒前S1抗原与HBVDNA定量检测相关性分析及临床应用价值

HBV Pre-S1antigen and its correlation with HBV DNA quantitative PCR detection and clinical applications as HBV replication markers

目的探讨乙型肝炎(乙肝)患者前S1(Pre S1)抗原检测和乙型肝炎病毒(HBV)DNA检测以及乙肝病毒血清标志物("乙肝五项")之间的关系,同时研究Pre S1抗原和HBV DNA在乙型肝炎诊断中的重要性。方法对537例乙肝患者血清用酶联免疫吸附试验(ELISA)法测定Pre S1抗原和HBV血清学标志物,用实时荧光定量聚合酶链反应(FQ-PCR)法进行HBV DNA检测,并对检测数据采用χ2检验进行比较分析。结果 537例乙肝患者血清中,HBV DNA总阳性率为52.70%;前S1抗原总阳性率为49.35%,两者间比较差异无统计学意义(χ2=1.21,P>0.05),而且Pre S1抗原和HBV DNA检测的符合率为93.62%。在HBV DNA阳性乙肝患者中Pre S1抗原检测阳性率为89.05%,HBeAg检测阳性率为37.46%,两者间差异有统计学意义(χ2=30.79,P<0.01)。结论 Pre S1抗原与HBV DNA具有高度相关性,并且能够比HBeAg更敏感地反映乙肝病毒的复制情况,Pre S1抗原可作为血清标志物检测的重要补充,更适合在无条件进行HBV DNA检测的基层医院开展。

Objective To study the correlation between pre S1 （Pre-S1） antigen detection and hepatitis B virus （HBV） DNA quantitative PCR （qPCR） as HBV replication markers. Methods A total of 537 hepatitis B pa- tients were recruited in the study. HBV Pre-S1 antigen and other HBV markers were detected by enzyme linked immunosorbent assay （ELISA） . HBV DNA was assayed by qPCR. Results Among 537 hepatitis B patients, the positive rates of HBV DNA and Pre-S1 were 52.70% and 49. 340/00, respectively （X2 =1.21, P 〉0.05） and the overlapping rates of these two methods was 93.62%. Pre-S1 antigen was positive in 89.05 of cases with HBV DNA positive while HBeAg positive was only 37.46% （X2 =30.79, P〈0.01）. Conclu- sions Pre-S1 antigen and HBV DNA are highly correlated to reflect the HBV replication status. Pre-Sl anti- gen detection can be a sensitive serum marker to reflect HBV replication.