乙型肝炎病毒表面大蛋白在抗病毒治疗中的临床意义

目的探讨乙型肝炎病毒表面大蛋白（LHBs）在监测抗病毒疗效上的临床意义。方法跟踪监测46例阿德谲韦酯治疗患者60周，分别采用ELISA法、时间分辨免疫荧光分析法和实时定量PCR法检测患者小同时间的LHBs、HBV血清学标志物和HBV DNA载量，并进行相关性分析。结果LHBs和HBV DNA下降趋势一致，其相关系数r=0．97，但LHBs消退晚于HBV DNA。治疗60周时共有20例患者的HBV DNA〈5×10^2／mL，其中8例LHBs转阴；疗效反复组14例患者HBV DNA转阴后又转阳，3例患者LHBs转阴；治疗无效组12例患者，2例LHBs转阴。结论动态监测LHBs可作为抗病毒治疗效果评价指标的有益补充.

Hepatitis B virus large surface protein in monitoring of antiviral treatment

Objective To evaluate hepatitis B virus large surface protein （LHBs） in monitoring of antiviral treatment. Methods LHBs, HBV serum markers and HBV DNA loads in 46 patients with adefovir dipivoxil （ADV） therapy were monitored for the whole course （60 weeks）. Enzyme linked immunosorhent assay （ELISA） , time differentiate immunofluoresence assay and real-time polymerase chain reaction （RT- PCR） were performed to detect LHBs, HBV serum markers and HBV DNA loads, respectively. And correlation analysis was also performed. Results Both LHBs and HBV DNA declined during the ADV treatment, and the correlation coefficient was 0. 97, hut LHBs declined after HBV DNA. There were 20 patients with HBV DNA 〈 5 × 10^2/mL at 60th week, in which 8 were LHBs negative; in 14 recurrent patients, the HBV DNA turned to negative and became positive again, 3 with negative LHBs; while in 12 patients resistant to the ADV therapy, 2 were LHBs negative. Conclusion Dynamic monitoring of LHBs is useful in the evaluation of antiviral treatment.