乙肝五项、PreS1Ag及HBV-DNA联合检测对乙型肝炎的诊断价值

Clinical value of combined detection of five markers of hepatitis B,PreS1Ag and HBV-DNA in diagnosis of hepatitis B

目的探讨对乙型肝炎采用乙肝五项、前S1抗原(PreS1Ag)及乙型肝炎病毒基因(HBV-DNA)联合检测的诊断价值。方法选择我院2019年1月至2020年6月收治明确诊断的乙型肝炎患者100例为研究对象。采集患者血清,以放射免疫分析法进行乙肝五项检测,以酶联免疫吸附法进行PreS1Ag的检测,并以荧光定量PCR法进行HBV-DNA水平的检测。分析不同HBV-M模式下PreS1Ag与HBV-DNA水平,比较HBsAg阳性下HBeAg阳性组与阴性组PreS1Ag阳性率以及HBV-DNA阳性组与阴性组PreS1Ag阳性率。结果不同HBV-M模式下PreS1Ag阳性率、HBV-DNA阳性率比较,差异无统计学意义(P>0.05)。HBsAg阳性模式下PreS1Ag阳性与PreS1Ag阴性组比较,HBV-DNA水平分布情况差异无统计学意义(P>0.05)。HBsAg阳性标本中HBeAg阳性组PreS1Ag阳性率为74.65%,高于阴性组阳性率的17.24%,差异有统计学意义(P<0.05)。HBsAg阳性样本中HBV-DNA阳性组PreS1Ag阳性率为94.64%,高于阴性组阳性率的58.82%,差异有统计学意义(P<0.05)。结论PreS1Ag可较好反映乙型肝炎病毒存在、复制情况,通过乙肝五项、PreS1Ag及HBV-DNA联合检测可发现低水平病毒感染,有利于乙型肝炎的早期诊断,值得推广。

Objective To explore the diagnostic value of the combined detection of five markers of hepatitis B,pre-S1 antigen(preS1Ag)and hepatitis B virus-DNA(HBV-DNA)in hepatitis B(HB).Methods A total of 100 patients who were admitted to our hospital from January 2019 to June 2020 and definitely diagnosed as HB were selected as the research objects.Sera of patients were collected,five markers of HB were detected by the radioimmunoassay,preS1Ag was detected by the enzyme-linked immunosorbent assay,and HBV-DNA level was detected by the fluorescence quantitative PCR.The levels of preS1Ag and HBV-DNA in different HBV-M modes were analyzed.The PreS1Ag-positive rates were compared between the HBeAg-positive group and the HBeAgnegative group under the HBsAg-positive mode,and the preS1Ag-positive rates were compared between the HBVDNA-positive group and the HBV-DNA-negative group.Results There were no significant differences in the PreS1Ag-positive rate and the HBV-DNA-positive rate under different HBV-M modes(P>0.05).There was no significant difference in the distribution of HBV-DNA between the preS1Ag-positive group and the preS1Ag-negative groupunder the HBsAg-positive mode(P>0.05).In HBsAg-positive specimens,the positive rate of preS1Ag was 74.65%in the HBeAg-positive group,which was significantly higher than that in the HBeAg-negative group(17.24%),with statistically significant difference(P<0.05).In HBsAg-positive samples,the positive rate of preS1Ag was 94.64%in the HBV-DNA-positive group,which was significantly higher than that in the HBV-DNA-negative group(58.82%),with statistically significant difference(P<0.05).Conclusion The preS1Ag can better reflect the existence and replication of HBV.Low-level HBV infection can be found through the combined detection of five markers of HB,preS1Ag and HBV-DNA,which is beneficial to the early diagnosis of HB and is worth popularization.