PreS_1和HBV-DNA与HBV-M相关性分析

目的:探讨乙肝病毒前S1抗原(PreS1Ag)在诊断慢性乙型病毒性肝炎病毒复制中的作用。方法:收集慢性乙型病毒性肝炎患者500例,其中HBV-DNA阳性400例(拷贝数>500/ml),按HBV-DNA含量由低到高分8组;其余为HBV-DNA阴性对照100例。检测乙肝血清标志物(HBsAg、HBeAg、HBeAb)与PreS1Ag。结果:(1)HBV-DNA<1×106/ml,PreS1Ag的阳性率比HBeAg高,两者比较差异有显著性(P<0.05);HBV-DNA1×106/ml以上,PreS1Ag与HBeAg相比差异无显著性(P>0.05)。(2)HBV-DNA<1×105/ml,PreS1Ag阳性率随着HBV-DNA含量增加而增加,不同组间的PreS1Ag阳性率相比差异有显著性(P<0.05)。(3)HBV-DNA<1×107/ml,HBeAg的阳性率随着HBV-DNA含量增加而增加,不同组间的HBeAg阳性率相比差异有显著性(P<0.05)。(4)HBV-DNA<1×106/ml,HBeAb有较高的阳性率,并随着HBV-DNA含量的增加而逐渐下降,不同组间的HBeAb阳性率相比差异有显著性(P<0.05)。(5)以HBV-DNA检测结果为金标准,HBeAg的灵敏度为68.5%(274/400),阴性预示值为43.2%(96/222),检测有效率为64.8%(324/500);均低于PreS1Ag的灵敏度90.0%(360/400),阴性预示值55.6%(50/90),检测有效率82.0%(410/500)。结论:PreS1Ag比HBeAg较准确的反映乙肝病毒的复制情况,是“乙肝五项”有益的必要补充。

Study of Correlation Between Hepatitis B Virus PreS1 Protein (PreS1) and HBV-DNA with Hepatitis B virus Markers (HBV M)

Objective To investigate the function of Pre S_1 in the diagnosis of hepatitis B virus reproduction. Methods 500 chronic B hepatitis patients’ sera were collected, 400 HBV-DNA positive patients(HBV-DNA >500 copies/ml) of which were divided into 8 groups by HBV-DNA levels, and else 100 HBV-DNA negative cases were as control. Both were examined the Pre S_1 (ELISA) and HBV M (electro-luminescence). Results The study showed (1) when HBV-DNA level in sera was less than 1×10~6 copies/ml, the positive rate of Pre S_1 was higher than that of HBeAg (P<0. 05); while there is no significant differences between Pre S_1 and HBeAg when HBV-DNA >1×10~6 copies/ml (P>0. 05).(2) when HBV-DNA level in sera was less than 1×10~5 copies/ml, the positive rate of Pre S_1 increased with HBV-DNA level and the rates among each groups were remarkably different (P<0.05). (3) when HBV-DNA level in sera was less than 1×10~7 copies/ml, the positive rate of HBeAg increased with HBV-DNA level and the rates among each groups were remarkably different (P<0.05). (4) when HBV-DNA level in sera was less than 1×10~6 copies/ml, the positive rate of HBeAb decreased as the HBV-DNA level increased and the rates among each groups were remarkably different (P<0.05). (5) by using the HBV-DNA results as the reference standard, the sensitivity of HBeAg was 61.8%(274/400), the negative prediction value(PV- ) of it was 43.2%(96/222) and the efficiency of it was 74.0%(324/450); those were all lower than the sensitivity 90%(360/400), the PV-55.6%(50/90) and the efficiency 82.1%(410/505) of Pre S_1 (P<0.05). Conclusions Serum Pre S_1 is a more exact laboratory marker for HBV-DNA reproduction than HBeAg, and is a helpful complementarity of traditional five HBV M.