前S1抗原检测在乙型肝炎临床诊断中的应用价值

Application Value of Pre S1 Antigen Test in Clinical Diagnosis of Hepatitis B

目的探讨乙型肝炎病毒前S1抗原(Pre-S1Ag)与乙肝病毒五项(HBs Ag、HBs Ab、HBe Ag、HBe Ab、HBc Ab)及HBV DNA相关性,探讨Pre-S1Ag检测的临床应用价值。方法从2014年1月—2015年6月期间在徐州医学院第二附属医院感染科住院的乙型肝炎患者中筛出HBs Ag阳性病例159例,采用ELISA法检测乙肝血清标志物和PreS1Ag,荧光定量PCR法检测标本HBV DNA。结果血清中HBe Ag、Pre-S1Ag和HBV DNA的阳性率分别为59.2%、81.7%和83.1%,Pre-S1Ag阳性率明显高于HBe Ag阳性率,HBe Ag抗原阳性组Pre-S1Ag的阳性率为97.8%。而HBe Ag抗原阴性组Pre-S1Ag阳性率为58.5%,HBe Ag阳性患者血清的Pre-S1Ag的阳性率明显高于HBe Ag阴性患者,差异有统计学意义(P<0.05)。Pre-S1Ag阳性率与HBV-DNA阳性率差异无统计学意义(P>0.05)。结论 Pre-S1Ag与HBV DNA符合率较高,对无条件检测HBV DNA而HBe Ag阴性的血清,Pre-S1Ag可作为HBV存在复制和传染性的重要检测指标。

Objective To discuss the correlation between the Pre-S1 Ag and HBs Ag, HBs Ab, HBe Ag, HBe Ab, HBc Ab and HBV DNA and study the clinical application value of Pre-S1 Ag test. Methods 159 cases of positive HBs Ag cases from January 2014 to June 2015 were selected and the hepatitis b serum marker and Pre-S1 Ag were tested by the ELISA method and the HBV and DNA were tested by the fluorescent quantitation PCR method. Results The positive rate of HBe Ag and Pre-S1 Ag and HBV DNA was respectively 59.2%, 81.7% and 83.1%, and the positive rate of Pre-S1 Ag was obviously higher than HBe Ag positive rate, and the Pre-S1 Ag positive rate in the HBe Ag antigen positive group and negative group was respectively 97.8% and 58.5%, and the positive rate of serum Pre-S1 Ag in patients with HBe Ag positive patients was obviously higher than that of patients with HBe Ag negative patients, and the differences were statistically significant(P<0.05),and the differences in the Pre-S1 Ag positive rate and HBV-DNA positive rate were not statistically significant(P>0.05).Conclusion The coincidence rate of Pre-S1 Ag and HBV DNA is higher, Pre-S1 Ag can be used as the important test index of HBV duplication and infection for the HBe Ag negative serum without conditions of testing HBV DNA.