PreS1Ag、HBeAg和HBV-DNA的对比检测与分析

目的:通过对比检测和分析739份血清中preS1蛋白、HBeAg和HBV-DNA的检测阳性率,为临床正确选用实验室指标防治乙型肝炎提供依据。方法:应用ELISA法对739份血清进行PreS1Ag和HBV血清标志物检测,并与实时荧光定量PCR检测HBV-DNA结果进行比较。结果:所有739份血清中,PreS1Ag阳性率为34.6%(256/739),HBeAg阳性率为30.7%(227/739),HBV-DNA阳性率为58.9%(435/739)。227份HBeAg阳性血清中,PreS1Ag阳性率55.9%(127/227),HBV-DNA阳性率96.0%(218/227);512份HBeAg阴性血清中,PreS1Ag阳性率25.2%(129/512),HBV-DNA阳性率为42.4%(217/512)。HBeAg、HBV-DNA和PreS1的阳性率有显著差异(P<0.05),阳性率高低依次为HBV-DNA>PreS1>HBeAg;HBeAg阳性血清中PreS1Ag(55.9%)阳性率显著高于HBeAg阴性血清PreS1Ag(25.2%)阳性率(χ2=36.5,P<0.01);HBV-DNA阳性血清的PreS1Ag检出率58.9%(256/435)显著高于HBV-DNA阴性血清的PreS1Ag检出率18.4%(56/304)(P<0.01);PreS1抗原与HBV-DNA阳性符合率为(200/256)78.1%,阴性符合率为(248/483)51.3%。598份HBsAg阳性血清(阳性率为80.9%,598/739)中HBeAg、PreS1和HBV-DNA阳性数(率)分别是224(37.5%)、253(42.3%)、417(69.7%)。结论:PreS1Ag、HBV-DNA、HBeAg的阳性率有显著性差异(P<0.05)。作为HBV感染和复制的指标,以检测HBV-DNA最为可靠,而PreS1Ag可能较HBeAg更敏感。在HBV感染的不同时期,如何理解和使用上述指标对防治乙型肝炎有重要意义。

Detecion of PreS1Ag, HBeAg and HBV - DNA and comparison their clinical significance

Objective:To compare the positive rate of HBeAg, Pres1Ag and HBV-DNA in 739 serum samples so as to offer the basis of selecting correctly examination indexes for the prevention and treatment of hepatitis B.Methods:The markers of Pres1Ag and HBV in 739 serum samples were detected by ELISA and the marker of HBV-DNA by real time fluorescence quantitative PCR(FQ PCR).The detected results were compared each other.Results:In all samples,the positive rates of Pres1Ag,HBeAg and HBV -DNA were 34.6%(435/739),30.7%(227/739) and 58.9%(435/739),respectively.In 227 samples with positive HBeAg,the positive rates of Pres1Ag and HBV-DNA were 55.9% and 96.0%,respectively.In 512 samples with negative HBeAg,the positive rates of Pres1Ag and HBV-DNA were 25.2% and 42.4%,respectively.The positive rate of Pres1Ag(58.9%) in samples with positive HBV-DNA was significantly higher than that in the samples with negative HBV-DNA(18.4%,P<0.01).The positive coincidence was 78.1%(200/256) and the negative coincidence was 51.3% between Pres1Ag and HBV-DNA.In 598 serum samples with positive HBsAg(80.9%,598/739),the positive rates of HBeAg,PreS1Ag and HBV-DNA were 37.5%,42.3% and 69.7%.Conclusion:There are significant differences of positive rate among HBeAg,PreS1Ag and HBV-DNA.HBV-DNA is more accurate for the detection of hepatitis B than the other two indexes,but PreS1Ag is more sensitive than HBeAg in judging the infection and replication of HBV.