乙型肝炎病毒Pre-S_1与乙肝血清学标志物联检的临床意义

Clinical Significance of Combined Measurements of Serum Pre-S_1 with other HBV Markers in Patients with Heatitis B

目的 :研究联合检测Pre -S1 及其它HBV标志物对测定HBV复制 (即传染性 )的意义。方法 :对341份HBsAg阳性的血清标本以ELISA法测定其Pre -S1 ,及其他四种HBV标志物 (HBsAb ,HBeAg ,HBeAb ,HBcAb)。结果 :341份标本中 ,Pre-S1 阳性者 (2 0 2份 )较HBeAg阳性者 (1 4 1份 )为多 ,两种标志物组合方式为 :单Pre -S1 阳性 (83份 ) ,单HBeAg阳性 (2 2份 ) ,两者均阳性者 (1 1 9份 ) ,此 2 2 4份标本被认为其病毒具有复制能力。结论 :向来以HBeAg(+)作为有传染性的标志。但Pre -S1 存在于Dane颗粒上 ,是复制的可靠标识。Pre -S1 与HBeAg联合检测比单纯一项测定可发现更多的有传染性病例 (本文中为 2 2 4例 ,与之相比单Pre-S1 为 2 0 2例 ,单HBeAg则只有 1 4 1例 )。

Objective To study the clinical significance of combined measurements of Pre-S 1 with other HBV markers for detection of meplication of HBV. Methods Pre-S 1 and other four markers (HBeAb, HBeAg, HBeAb, HBcAb) were detected in 341 specimens of HBsAg(+) serum with ELISA. Results In the 341 specimens, there were more Pre-S 1 positive specimens n=202 than HBeAg positive ones ( n=141 ). Combination modes of the two markers were as follows: Pre-S 1 positive only ( n=83 ), HBeAg positive only ( n=22 ) and both positive ( n=119 ); replicable HBV was considered to be present in these 224 specimens. Conclusion Traditionally, we took HBeAg(+) patients as being infectous. However, Pre-S 1 is located on Dane granule and is a reliable indicator of replication. Combined measurement of Pre-S 1 with HBeAg will detect more infectious cases than measuremant of either marker alone (in this study, 224 vs 202 with Pre-S 1 only and 141 with HBeAg only).