各类慢性乙型肝炎患者HBV前S2抗原与HBV感染血清标志物及HBVDNA的关系

目的探讨乙型肝炎病毒(HBV)前S2抗原(preS2Ag)与HBV感染5项标志物(HBV-M)、HBV DNA之间的关系及对慢性乙型肝炎分类诊断的临床意义。方法对584例各类慢性乙型肝炎患者血清采用放射免疫法(R IA)检测preS2Ag,用酶联免疫吸附试验(ELISA)检测HBV-M(HBsAg、抗HBs、HBeAg、抗HBe、抗HBc),用聚合酶链反应(PCR)检测HBV DNA。结果慢性乙型肝炎轻度、中度、重度及肝炎后肝硬化患者preS2Ag的检出率分别为45.98%、67.10%、83.87%及92.86%;preS2Ag在HBeAg阳性、HBV DNA>105拷贝/mL患者中检出率明显高于HBeAg阴性、HBV DNA<105拷贝/mL患者,差异有统计学意义(P<0.001)。结论preS2Ag的检出意味着病毒有复制或有传染性;开展preS2Ag的检测有助于慢性乙型肝炎的分类、慢性乙型肝炎急性发作和预后的判断。

The correlation between hepatitis B virus preS2 antigen and other hepatitis B virus markers or DNA in patient with chronic hepatitis B

Objective To study the correlation between hepatitis B virus(HBV) preS2 antigen(preS2Ag),other HBV markers(HBV-M) and HBV DNA and its clinical significance in the diagnosis of hepatitis B. Methods 584 serum samples from patients with several type hepatitis B were tested for preS2Ag by radioimmunoassay(RIA),HBV-M(HBsAg,anti-HBs,HBeAg,anti-HBe,anti-HBc) by enzyme-linked immunosorbent assay (ELISA),and HBV DNA by polymerase chain reaction(PCR) respectively. Results The preS2Ag positive rate of mild,middle,severe patients with chronic hepatitis B and posthepatitic cirrhosis were 45.98%,67.10%,83.87% and 92.86% respectively.The preS2Ag pasitive rate in the patients with HBeAg-pasitive and HBV DNA>10~5 copy/mL was significantly higher than that in the patients with HBeAg-negative and HBV DNA<10~5 copy/mL(P<0.001). Conclusions PreS2Ag positive means that HBV virus are replicating or the patient is infectious.The preS2Ag determination is helpful for judging the acute exacerbation in patients with chronic hepatitis B,the diagnosis in several type of chronic hepatitis B and prognosis.