乙型肝炎病毒preS1与乙肝两对半和HBVDNA联合检测的临床价值分析

Clinical value analysis of combined detection of Hepatitis B Virus pre S1 protein antigen, five indexes of Hepatitis B and HBV DNA of patients with Hepatitis B in clinical diagnosis

目的分析乙型肝炎病毒前S1蛋白抗原（pre S1）、乙肝两对半、乙肝病毒基因（HBV DNA）联合检测在乙肝患者临床诊断中的应用价值。方法选取2011年4月-2014年4月我院住院及门诊收治的160例乙肝患者作为研究对象,于清晨空腹条件下取其血清标本,采用酶联免疫法检测血清pre S1及乙肝两对半水平,同时采用荧光定量扩增技术检测血清内HBV-DNA水平。结果大三阳组患者前S1抗原与乙肝HBV DNA阳性率均明显高于其他HBV-M模式,组间对比差异显著（P〈0.05）,HBs Ag阳性HBc Ab阳性组前S1抗原阳性率明显高于小三阳组（P〈0.05）;前S1抗原阳性组HBV DNA阳性率明显高于对应前S1抗原阴性组,其中以HBs Ag＋HBe Ag＋HBc Ab＋pre S1＋组HBV DNA阳性率最高,且其HBV DNA含量水平同样最高;146例HBs Ag阳性患者中,137例Hbe Ag阳性,阳性率为93.8%,且其中HBe Ag＋组,前S1抗原阳性率为88.9%,明显高于HBe Ag-组,组间对比差异显著（P〈0.05）;HBs Ag阳性患者HBV DNA阳性100例,阳性率68.5%。且HBV DNA阳性组前S1抗原阳性率为85.0%,明显高于HBV DNA-组,提示HBs Ag阳性患者血清中pre S1与HBV DNA相关性较强（P〈0.05）。结论采取三项联合检测,可在尽早时间内发现乙肝患者病毒感染情况,为患者的诊断与治疗提供指导。

Objective To analyze the application value of combined detection of Hepatitis B Virus（HBV） pre S1 protein antigen, five indexes of Hepatitis B and HBV DNA of Patients with Hepatitis B in Clinical Diagnosis. Methods 160 patients with Hepatitis B who were admitted to our hospital from April 2011 to April 2014 were selected as research subjects. Patients＇ serum samples in fasting condition were collected in the morning. Serum pre S1 and five indexes of Hepatitis B were detected by enzyme linked immunoassay and level of HBV DNA in serum was detected by fluorescent quantitative PCR at the same time. Results Positive rates of pre S1 antigen and HBV DNA of patients in the great three positive group was all significantly higher than other HBV-M models. The compared groups have significantly differences（P〈0.05）. Positive rates of pre S1 antigen in the HBe Ag and HBc Ab positive group was significantly higher than that in the small three positive group（P〈0.05）. Positive rate of HBV DNA in positive pre S1 antigen group was significantly higher than that in the negative pre S1 antigen group, of which, positive rate of HBV DNA in HBs Ag＋HBe Ag＋HBc Ab＋pre S1＋ group was highest and level of HBV DNA in this group was also highest. Among 146 HBs Ag positive patients, 137 were positive HBe Ag patients and positive rate of it was 93.8%. Positive rate of pre S1 antigen was 88.9% in HBe Ag＋ group which was significantly higher than that of HBe Ag-group. These compared groups have significantly differences（P〈0.05）. 100 HBV DNA cases were in positive HBs Ag patients and the positive rate was 68.5%. Positive rate of pre S1 antigen in positive HBV DNA group was 85.0% which was significantly than that of HBV DNA- group. It suggested that there was a strong correlation between serum pre S1 and HBV DNA in positive HBs Ag patients（P〈0.05）. Conclusion Combined detection of the three items can discover infection situation of Hepatitis B Virus as soon as possible to give instructions for diagnosis and treatment of patients.