前S1蛋白与病毒DNA和核心抗原对乙型肝炎病毒复制诊断的对比

目的 分析前S1(Pre-S1)蛋白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共104例,均经肝活组织检查证实。检测其Pre S1蛋白,HBV标志物与HBV DNA。结果 HBsAg、HBeAg、抗-HBc阳性者29例,HBV DNA与Pre-S1蛋白的检出率均达96.5％,这组患者存在病毒的高复制。HBsAg、抗-HBe和抗-HBc阳性者65例,HBV DNA与Pre-S1蛋白的检出率分别为81.5％和72.3％;HBsAg和抗-HBc阳性者8例,HBV DNA与Pre-S1蛋白的检出率分别为87.5％、75.0％,说明部分HBeAg阴性而抗-HBe阳性/阴性的患者仍存在着病毒复制。以HBV DNA定量>103拷贝/ml为诊断标准,HBV DNA阳性患者HBeAg、Pre-S1蛋白的检出率分别为31.5％(28/89)、80.9％(72/89);两者与HBV DNA的总符合率分别为40.0％(42/104)、82.0％(85/104)。HBV DNA与HBeAg检出率差异有显著性(x2=53.397,P<0.001);HBV DNA与Pre-S1蛋白检出率差异无显著性。 结论Pre-S1蛋白较HBeAg更敏感的反映了HBV复制的情况。

The contrast study of Pre-S1 protein, HBV-DNA and HBeAg in diagnosing viral replication in patients with chronic hepatitis B

Objective To determine the role of Pre-S1 protein in diagnosing viral replication in patients with chronic hepatitis B. Methods 104 consecutive patients with chronic hepatitis B were included in the study, liver biopsy were performed in all patients. Serial serum samples were studied with the quantitative determination of HBV-DNA by a quantitative PCR assay, determination of Pre-Sl protein by ELISA. Results The positive rates of HBV-DNA and Pre-Sl protein in patients with HBsAg HBeAg anti-HBc( ) both were 96.5%. The positive rates of HBV-DNA and Pre-Sl protein in patients with HBsAg anti-HBe anti-HBc( ) were 81.5%, 72.3%, respectively. The positive rates of HBV-DNA and Pre-Sl protein in patients with HBsAg anti-HBc( ) were 87.5%,75.0%, respectively. It represented some patients with HBeAg (-) anti-HBe ( /-) still had viral replication. HBV-DNA>103 copy/ml as positive criteria for diagnosing viral replication, the positive rate of HBeAg, Pre-Sl were 31.5%(28/89), 80.9% (72/89) in patients with HBV-DNA>103 copy/ml, respectively. The concordance rates of HBeAg, Pre-Sl with HBV-DNA were 40.0% (42/104), 82.0%(85/104), respectively. Conclusion It showed that Pre-S 1 was more sensitive than HBeAg in diagnosing viral replication in patients with chronic hepatitis B.