HBV-DNA含量及Pre-S1检测在诊断乙肝病毒复制中的临床意义

目的了解乙肝患者不同血清学标志物模式(HBV-M)与乙肝病毒DNA含量及乙肝病毒前S1蛋白的关系,为预测乙型肝炎病毒的传染程度、乙肝的预防、诊断及治疗提供实验室依据。方法采用美国ABBOTT公司生产的AXSYM全自动免疫分析仪和微粒子酶免检测试剂盒对456例携带不同血清学标志物的乙肝患者进行乙肝五项指标检测,并用聚合酶链反应定量检测血清HBV-DNA含量,同时,用ELISA法检测乙肝病毒前S1抗原。结果五种HBV免疫模式中HBsAg、HBeAg和HBcAb同时阳性,其HBV-DNA定量阳性和HBV-PreS1的检出率分别为94.1%和81.2%;HBsAg、HBeAb和HBcAb阳性组的检出率分别为53.4%和43.7%;其他不同血清学模式组也有不同的阳性率。结论Pre-S1可敏感反映乙型肝炎病毒的复制情况,尤其可反映HBeAg阴性的乙肝患者仍存在病毒复制。HBV-DNA、乙肝病毒五项标志和前S1蛋白联合检测,对更好地早期诊断HBV感染,了解病毒的复制情况,疗效观察和预后判断均具有重要意义。

Clinical Signification of Detecting HBV- DNA and HBV - PreS1 Protein in Identification of Viral Replication Activity in Patients With HBV

Objective To study the relationship between the serological markers of Hepatitis B and the quantity of HBV-DNA and HBV-PreS1,and to provide laboratory basis for predicting the infectivity,prevention and treatment of Hepatitis B. Methods Five serological markers of Hepatitis B were detected with Abbott AXSYM immunoassay analyzer and micro-particles enzyme immunoassay kits,HBV-DNA was determined by real-time quantitative PCR and HBV-PreS1 was measured with ELISA from 520 patients with Hepatitis B.Results The HBV-DNA and HBV-PreS1 positive rates in the HBsAg( ),HBeAg( ) and HBcAb( ) group were 94.1% and 81.2% respectively,while in the HBsAg( ),HBeAb( ) and HBcAb( ) group they were 53.4%%and 43.7% respectively.The HBV-DNA and HBV-PreS1 positive rates varied accordingly.Conclusion HBV-PreS1 protein sensitively reflects the viral replication status,especially when HBeAg is negative.It is of great value to monitoring the HBV-DNA,5 serological markers and HBV-PreS1 synchronous in the diagnosis of HBV infection, investigation of reproduction,therapeutic observation and evaluation of prognosis.