乙型肝炎病毒前S_2抗原抗体系统检测的临床意义

Clinical significance of detecting hepatitis B virus PreS_2 antigen and PreS_2 antibody

目的探讨前S2抗原抗体系统检测的临床意义。方法采用ELISA法对92例标本进行HBVM和PreS2-Ag及PreS2-Ab检测,将其结果的相关性进行分析。结果PreS2-Ag在HBsAg阳性组、HBeAg阳性组的检出率分别为64.71%、96.97%,均明显高于其在对应阴性组中的检出率(P<0.01);PreS2-Ag与HBsAg、HBeAg的符合率分别为73.91%、85.87%,PreS2-Ag的阳性率低于HBsAg的阳性率但高于HBeAg的阳性率,PreS2-Ag与HBsAg、HBeAg的总体检出率间均关联显著(P<0.01),PreS2-Ag与HBeAg的不一致部分相差显著(P<0.01),表明PreS2-Ag与HBsAg、HBeAg均高度相关,PreS2-Ag优于HBeAg。PreS2-Ab在HBeAb阳性组中的检出率(72.22%)明显高于在HBeAb阴性组中的检出率(23.21%)(P<0.01),PreS2-Ab与HBeAb符合率为75%,二者之间差异无显著性(P>0.05),说明PreS2-Ab与HBeAb总体上具有一定平行关系。结论PreS2-Ag是HBV感染、复制的敏感指标,且优于HBeAg;PreS2-Ag与PreS2-Ab的连续监测对HBV感染与复制的判断和抗病毒疗效及病情预后的动态观察有重要意义。

Objective To explore the clinical significance of detecting hepatitis B virus PreS 2 antigen and PreS 2 antibody.Methods HBVM,PreS 2 antigen and PreS 2 an-tibody of92serum samples were determined by ELISA,and the relationships of the re-sults of above tests were analyzed.Results The positive rate of the PreS 2 antigen in the HBsAg-positive group and HBeAg positive group were64.71%,96.97%respetively,and the positive groups were significantly higher than that in the negative group(P<0.01).The corresponding rates beween PreS 2 antigen and HBsAg or HBeAg were73.91%,85.87%respectively.The positive rate of the PreS 2 antigen was lower than that of HB-sAg ,but higher than that of HBeAg .There was significant association between total de-tection rate of the PreS 2 antigen and HBeAg and HBsAg(P<0.01),and there was signifi-cant difference between the fraction of discordance of the PreS 2 antigen and HBeAg.The positive rate of the PreS 2 antibody in the HBeAb-positive group(72.22%)was signif-icantly higher than that in the HBeAb-negative group (23.21%),The corresponding rate of the PreS 2 antibody with HBeAb was75%,with no significant difference between PreS 2 antibody and HBeAb.Conclu sions It is suggested that the PreS 2 antigen may be served as a sensitive marker for hepatitis B virus infection and replication.It is very important to diagnose premier infection and situation of replication of HBV,and to ob-serve the effect and prognosis of hepatitis B by detecting PreS 2 -Ag and PreS 2 -Ab con-tinually.