乙型病毒性肝炎患者前S1抗原检测的意义

目的:探讨乙型肝炎病毒前S1抗原在临床上的应用价值。方法:采用酶联免疫吸附试验(ELISA)和聚合酶链反应(PCR)方法,对306例乙型病毒性肝炎(以下简称乙肝)患者和50例健康人分别检测HBV标志、preS1抗原和乙肝病毒-脱氧核糖核酸(HBV-DNA)。结果:306例乙型肝炎患者preS1抗原和HBV-DNA的检出率分别为53.6%和58.8%;preS1-Ag在HBeAg阳性组和HBeAg阴性组中的阳性率分别为90.9%、29.2%,HBV-DNA在HBeAg阳性组和HBeAg阴性组中的阳性率分别为95.9%、34.6%,以HBV-DNA测定结果为判断标准,则preS1-Ag的敏感性、特异性、阳性和阴性预测值及符合率分别为87.8%、95.2%、96.3%、84.5%和90.8%;HBV-DNA检出率稍高于PreS1-Ag的检出率,但两者的检出率差异无统计学意义(P>0.05)。结论:乙肝病毒PreS1抗原与HBeAg阳性、HBV-DNA阳性呈高度相关,PreS1-Ag可与HBeAg、HBV-DNA同时作为HBV存在复制和传染性的重要检测指标,值得临床实验室推广应用。

The Significance of Pre-S1 Antigen Detection in Patients with Hepatitis B Virus

Objective:To investigate the clinical significance of preS1-Ag of Hepatitis B Virus(HBV).Methods:The markers,preS1-Ag and DNA of HBV were determined by ELISA and PCR in 306 patients with Hepatitis B and 50 heathy person.Results:The positive rates of preS1-Ag and HBV-DNA in all patients were 53.6% and 58.8%,the two rates were 90.9% and 95.9% in HBeAg positive group and were 29.2% and 34.6% in HBeAg negative group,if the results of HBV-DNA is the golden standard,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of preS1-Ag was 87.8%,95.2%,96.3%,84.5% and 90.8%,respectively.The detection of HBV-DNA was little higher than that og HBV preS1-Ag,but no significant difference was found between them(P>0.05).Conclusions:PreS1-Ag of HBV is highly related to HBeAg and HBV-DNA,they all can be used as markers for HBV infection.It is believed that preS1-Ag may be widely used in clinical laboratory.