乙肝不同血清模式及乙肝DNA定量与前S1抗原联合检测的临床意义

目的 探讨乙型肝炎患者不同的血清学模式、乙肝病毒DNA(HBV-DNA)与乙肝前S1抗原(Pre-S1 Ag)联合检测的临床意义.方法 采用化学免疫发光法(CLIA)定量筛选339例乙肝血清标志物阳性血清,采用荧光定量聚合酶链反应法(FQ-PCR)检测HBV-DNA,采用酶联免疫吸附法(ELISA)检测Pre-S1 Ag.结果 乙肝不同血清模式下,HBV-DNA与Pre-S1 Ag检测结果比较差异无统计学意义(P＞0.05).HBsAg、HBeAg、抗-HBc阳性组HBV-DNA检出率93.1％,Pre-S1Ag检出率86.1％.HBsAg、HBeAb、抗-HBc阳性组HBV-DNA检出率45.9％,Pre-S1 Ag检出率69.2％.HBsAg、抗-HBc阳性组HBV-DNA检出率61.0％,Pre-S1 Ag检出率72.9％.HBsAg、HBeAg阳性组HBV-DNA及Pre-S1 Ag检出率均为100％.以HBeAg阳性为对照HBV-DNA及Pre-S1 Ag检出率分别为87.3％和93.7％.HBV-DNA与Pre-S1 Ag检测结果比较差异有统计学意义(P＞0.05).结论 乙肝五项、HBV-DNA、Pre-S1Ag联合检测能够对乙肝病毒的感染、复制程度做出准确的判断,为临床治疗方案的选择和疗效的观察提供可靠的依据.

Clinical values of combined analysis on serological patterns,virus DNA titer and pre-S1 antigen for hepatitis B

Objective To discuss clinical values of the combined analysis on serological patterns, virus DNA titer and pre-S1 antigen for hepatitis B.Methods Serum samples from 339 patients with chemical luminescent immunoassay (CLIA) positive results were used in the study.The level of serum HBV-DNA was detected by fluorescent quantitative polymerase chain reaction (FQ-PCR).Pre-S1Ag was detected by ELISA.Results There was no significant differences in pre-S1 Ag or HBV-DNA with different serological patterns of hepatitis B (P ＞ 0.05).The HBV-DNA positive rate of the HBsAg, HBeAg and Anti-HBc positive group was 93.1％ while the pre-S1Ag positive rate was 86.1％.The HBV-DNA positive rate of the HB-sAg, HBeAb, anti-HBc positive group was 45.9％ and the Pre-S1Ag positive rate was 69.2％.The HBV-DNA positive rate of the HBsAg, anti-HBc positive groups was 61.0％.The Pre-S1Ag positive rate was 72.9％.The HBV-DNA and Pre-S1Ag positive rate of the HBsAg, HBeAg positive groups were 100％.The HBV-DNA and Pre-S1Ag positive rates were 87.3％ and 93.7％ in HBeAg positive samples, respectively.There were statistically significant differences in results of HBV-DNA or pre-S1 Ag(P ＜ 0.05).Conclusions Combined detection on serological patterns, virus DNA titer and pre-S1 antigen for hepatitis B have important clinical values in correct identification of the HBV infection and replication status.It provides reliable evidences for the selection of methods intreatment and observation of clinical efficacy.