对乙型肝炎患者检测乙肝表面抗原大蛋白和前S_1抗原的区别和临床意义

目的检测乙型肝炎(下称乙肝)患者血清中乙肝表面抗原大蛋白(LHBs)、乙肝前S1、HBV-DNA,探讨LHBs用于乙肝患者临床诊断的意义。方法采用酶联免疫吸附实验(ELISA)检测LHBs以及乙肝前S1,采用化学发光方法检测乙肝两对半,采用荧光定量PCR方法对患者HBV-DNA进行检测。结果 (1)相同乙肝模式患者血清LHBs与HBV-DNA检出率差异无统计学意义(P0.05);(2)HBeAg阳性患者血清中LHBs与HBV-DNA阳性率均明显高于HBeAg阴性患者,差异有统计学意义(P0.05);(3)相同乙肝模式患者血清乙肝前S1的检出低于HBV-DNA的检出,两者差异有统计学意义(P0.05)。结论 LHBs可以弥补由于乙肝病毒变异引起的HBeAg检测的不足,并在一定程度上反映了乙肝患者肝功能状况。

The clinical significance of LHBs and HBV pres1 in patients with HBV

Objective To explore the clinical significance of HBV large protein （LHBs） in diagnosing viral replication,we detected the LHBs,HBV-DNA,HBV preS1,ALT and the hepatitis B viral markers（HBV M） in the serum of the patients infected with HBV.Methods LHBs,HBV preS1 and HBV M were analyzed by using ELISA. The HBV-DNA was quantitatively detected by using real-time detection polymerase.Results （1）No significant difference between the detectable rate of HBV-DNA and LHBs was found in the same HBV M（P0.05）.（2）The positive rates of LHBs and HBV-DNA in HBeAg positive patients were higher than that in HBeAg negative patients （P0.05）.（3）The detectable rate of HBV-DNA was higher than that of HBV preS1,which was found in the HBV M,and it was of a significant difference（P0.05）.Conclusion There is a perfect correlation between the positive rate of LHBs and HBV-DNA,and LHBs is a reliable serological marker that can reflect the replication of HBV. The average value of ALT in LHBs positive patients was higher than that of LHBs nagetive patients,and the result showed that LHBs can also reflect liver function.