HBeAg阴性慢性乙肝患者血清前S1抗原与HBV DNA的关系

目的通过分析HBV Pre-S1抗原与HBV DNA的关系,探讨HBeAg阴性慢性乙肝患者血清前S1抗原检测的临床价值。方法采用ELISA法、荧光定量PCR法及生化检测270例HBeAg阴性慢性乙肝患者及50例健康对照血清Pre-S1抗原、HBV DNA及肝功能,并对检查结果进行相关性分析。结果 270例HBeAg阴性血清中,Pre-S1抗原和HBV DNA阳性率分别为39.6%和41.9%,Pre-S1抗原与HBV DNA存在相关性（χ^2=187.0,P〈0.01）;Pre-S1抗原阳性组AST、ALT、TBIL、γ-GT均高于阴性组（P〈0.01）;当HBV DNA拷贝数的对数值〉2.7时,Pre-S1抗原诊断敏感度85.8%,特异度93.6%,准确性90.4%,阳性预测值90.7%,阳性似然比13.4,优势比89.1。结论 HBV Pre-S1抗原与HBV DNA、肝功能均有较好相关性,在HBeAg阴性慢性乙肝患者中,它能够敏感、准确地反映HBV的复制和肝功能状况,可作为乙肝病毒复制的一项新传染性指标。

Relationship between serum Pre-S1 antigen and HBV-DNA in patients with HBeAg-negative chronic hepatitis B

Objective To explore the clinical value of serum Pre-S1 antigen detection in HBeAg-negative chronic hepatits B patient’s,according to the correlation between Pre-S1 antigen and HBV-DNA.Methods Two hundred and seventy HBeAg-negative chronic hepatitis B patients and 50 healthy controls serum specimens were collected,their Pre-S1 antigen was detected by ELISA,HBV DNA level was detected by fluorescence quantitative polymerase chain reaction(FQ-PCR),liver fuction(ALT,AST,TBIL and γ-GT) were detected by automatic biochemical analyzer respectively.The correlation among the detection results was analyzed.Results The positive rates of Pre-S1 antigen and HBV DNA in 270 HBeAg-negative chronic hepatitis B patients were 39.6% and 41.9% respectively.Pre-S1 antigen was correlated with HBV-DNA(χ2=187.0,P<0.01).AST,ALT,TBIL and γ-GT of Pre-S1 antigen positive group were higher than those of negative group(P<0.01).When logarithm of HBV-DNA copies was more than 2.7,the sensitivity,specificity,accuracy,positive predictive value(PPV),positive likelihood ratio(PLR) and odds ratio(OR) of Pre-S1 antigen were 85.8%,93.6%,90.4%,90.7%,13.4,89.1 respectively.Conclusion Pre-S1 antigen is correlated with HBV-DNA and liver function,it can reflect HBV replication and liver function sensitively and accurately and can be taken as a new serological indicator for infectivity and replication of HBV.