乙肝不同血清模式及乙肝DNA定量与前S1抗原联合检测的临床意义

Clinical values of combined analysis onserological patterns, virus DNA liter and pre-S1 antigen for hepatitis B

目的探讨乙型肝炎患者不同的血清学模式、乙肝病毒DNA（HBV-DNA）与乙肝前sl抗原（Pre．SlAg）联合检测的临床意义。方法采用化学免疫发光法（CLIA）定量筛选339例乙肝血清标志物阳性血清，采用荧光定量聚合酶链反应法（FQ—PCR）检测HBV-DNA，采用酶联免疫吸附法（ELISA）检测Pre．S1Ag。结果乙肝不同血清模式下，HBV．DNA与Pre-SlAg检测结果比较差异无统计学意义（P〉0．05）。HBsAg、HBeAg、抗一HBc阳性组HBV—DNA检出率93．1％，Pre—S1Ag检出率86．1％。HBsAg、HBeAb、抗．HBc阳性组HBV-DNA检出率45．9％，Pre—S1Ag检出率69．2％。HBsAg、抗．HBc阳性组HBV-DNA检出率61．0％，Pre-SlAg检出率72．9％。HBsAg、HBeAg阳性组HBV-DNA及Pre．SlAg检出率均为100％。以HBeAg阳性为对照HBV—DNA及Pre—S1Ag检出率分别为87．3％和93．7％。HBV．DNA与Pre．SlAg检测结果比较差异有统计学意义（P〉0．05）。结论乙肝五项、HBV．DNA、Pre．SlAg联合检测能够对乙肝病毒的感染、复制程度做出准确的判断，为临床治疗方案的选择和疗效的观察提供可靠的依据。

Objective To discuss clinical values of the combined analysis on serological patterns, vi- rus DNA titer and pre-S1 antigen for hepatitis B. Methods Serum samples from 339 patients with chemical luminescent immunoassay （CLIA） positive results were used in the study. The level of serum HBV-DNA was detected by fluorescent quantitative polymerase chain reaction （FQ-PCR）. Pre-S1Ag was detected by ELISA. Results There was no significant differences in pre-S1 Ag or HBV-DNA with different serological patterns of hepatitis B （P 〉 0.05）. The HBV-DNA positive rate of the HBsAg, HBeAg and Anti-HBc posi- tive group was 93.1% while the pre-S1Ag positive rate was 86. 1%. The HBV-DNA positive rate of the HB- sag, HBeAb, anti-HBc positive group was 45.9% and the Pre-S1Ag positive rate was 69.2%. The HBV- DNA positive rate of the HBsAg, anti-HBc positive groups was 61.0%. The Pre-SIAg positive rate was 72. 9%. The HBV-DNA and Pre-S1Ag positive rate of the HBsAg, HBeAg positive groups were 100%. The HBV-DNA and Pre-S1Ag positive rates were 87.3% and 93.7% in HBeAg positive samples, respectively. There were statistically significant differences in results of HBV-DNA or pre-S1 Ag（P 〈 0.05）. Conclusions Combined detection on serological patterns, virus DNA titer and pre-S1 antigen for hepatitis B have important clinical values in correct identification of the HBV infection and replication status. It provides reliable evidences for the selection of methods intreatment and observation of clinical efficacy.