HBV前S1抗原与血清标志物的相关性及临床评价

目的分析HBV前S1抗原(Pre-S1Ag)与HBV血清标志物(M)的相关性确定其临床检测的价值。方法收集乙型肝炎患者及乙型肝炎携带者共245例,和45例抗病毒治疗1年治疗前后的留置血清,检测其Pre-S1Ag和HBV-M及HBV -DNA。结果检测分析245份乙型肝炎患者及携带者的Pre -S1Ag和HBV -M及HBV-DNA ,发现HBsAg、HBeAg和抗-HBc均阳性者组Pre-S1Ag与HBV-DNA的检出率分别为95.3%和94.1%,在HBsAg阳性,HBeAg/HBeAb阴性,抗HBc阳性组中,Pre-S1Ag与HBV-DNA检出率分别为83.3%和85.4% ,Pre-S1Ag高检出率伴随HBV-DNA阳性率,HBV-DNA与Pre-S1Ag检出相关性差异无显著性,x2=3.40,P>0.05;HBV-DNA与HBeAg比,x2=88.01,P<0.001,检出率差异有显著性,Pre-S1Ag的检出率及与HBV-DNA的符合率显著高于HBeAg,在HBeAg阴性抗-HBe阳性组中,Pre-S1Ag仍能达到较高的检出率73.8%。45份HBsAg、HBeAg和抗-HBc均阳性者组患者留置血清在用抗病毒药物治疗1年后检测其用药前后Pre -S1Ag和HBV -M及HBV -DNA ,发现HBeAg和HBV-DNA有不同程度的阴转时,Pre-S1Ag并无明显的改变。结论Pre-S1Ag比HBeAg更能敏感地反映乙型肝炎的复制,尤其对HBeAg阴性的患者更具临床价值,对临床观察抗病毒治疗疗效可能有指导意义。

Clinical evaluation of Pre- S1Ag and its relationship to HBV markers in serum

Objective:To analyse the relationship of Pre-S1Ag to HBV-markers and to evaluate its clinical significance.Methods:The Pre-S1Ag and HBV-Mas well as HBV-DNA in serum from245cases with chronic HBV infection and45cases with anti-viral treatment for one year were respectively detected by using commerical detective kit in this paper.Results:The positive rates of Pre-S1Ag and HBV-DNA are95.3%and94.1%in the group of cases with HBeAg positive,83.3%and85.4%in the group of cases with HBsAg positive,HBeAg/HBeAb negative and HBcAb positive respectively.High detectable rate of Pre-S1Ag is in concomitance with HBV-DNA.The coincidence in Pre-S1Ag and HBV-DNA is remarkable(P>0.05),and poor in HBeAg and HBV-DNA(P<0.01),so that there is still as high as73.8%positive rate of Pre-S1Ag in HBeAg negative group.In45cases with anti-viral treatment for one year,there is no obvious change of Pre-S1Ag detectable rate in groups of having HBeAg and HBV-DNA serum negative-conversion.Conclusion:Pre-S1Ag can more sensitively reflect the viral replication than HBeAg in patients with HBVinfection,especially in cases with HBeAg negative,and it has more clinical significance for instructing the anti-HBV therapy.