检测表面大蛋白对HBeAg阴性乙型肝炎的临床评价

目的 检测乙型肝炎患者血清中3种HBV标志物(HBV-M)模式的HBV表面大蛋白(LHBs)和HBV DNA,对比并观察其相关关系,探讨HBeAg阴性的乙型肝炎检测LHBs的临床价值.方法 对534例乙型肝炎患者中的HBeAg阴性者346例,以ELISA法进行LHBs和HBV-M检测,荧光定量PCR方法 进行HBV DNA检测,并与HBeAg阳性者的检测结果 作比较.结果 534份乙型肝炎患者的LHBs、HBV DNA检测结果 显示:L组(大三阳)LHBs与HBV DNA检测阳性率分别为95.21%和86.17%,两种检测方法 之间有很好的相关性;S组(小三阳)及DN组(HBeAg和抗-Hbe均阴性)LHBs与HBV DNA阳性率分别为73.67%、81.48%和42.32%、55.56%,差异均有统计学意义(P<0.01,P<0.05);HBeAg阴性的346例样本中LHBs与HBV DNA的阳性率分别为71.39%和43.35%,差异有统计学意义(P<0.01),其中HBV DNA检测的196例阴性样本经LHBs检测阳性率为68.88%.结论 LHBs可作为从蛋白水平反映乙型肝炎患者体内病毒复制的血清学指标,且与HBV DNA检测具有很好的相关性,特别对于HBeAg阴性的患者LHBs检测可作为体内HBV复制及预后判断的较好血清免疫学指标.

Clinical assessment of detecting LHBs for the HBeAg negative hepatitis B

Objective To detect large surface protein (LHBs)and HBV DNA on 3 HBV-M and compare their difference, to study the relation between LHBs and HBV DNA and to explore the clinical value of detecting LHBs among HBeAg negative in the patients with hepatitis B. Methods 346 HBeAg negative patients among 534 cases were detected LHBs and HBV DNA respectively. LHBs were measured by ELISA,while serum HBV DNA level by fluorescent quantitative PCR, and the results were also compared to those observed form HBeAg positive patients. Results There was no statistical difference between the positive rates of LHBs and HBV DNA in L group, the result to were 95.21% and 86.17% respectively (P>0.05), and showed a good correlation. The positive rates of HBV DNA and LHBs among S and DN groups were 73.67%, 81.48% and 42.32%, 55.56% respectively and showed statistical difference between LHBs and HBV DNA(P<0.01). In 346 cases with HBeAg-negative, the positive rates of LHBs and HBV DNA were 71.39% and 43.35% respectively and showed statistical difference (P<0.01). Among 196 HBV DNA negtive cases, the positive rates of LHBs were 68.88 %. Conclusions LHRs is correlated closely with the levels of HBV DNA, it would be a good immuno-serological index reflecting HBV replication and prognosis criterion for HBeAg negative patients.