乙型肝炎患者前S1抗原与HBV-DNA和HBeAg的相关性研究

目的 探讨乙型肝炎患者前S1抗原(Pre-S1-Ag)与HBV-DNA、HBeAg的相互关系,并评价Pre-Sl-Ag在反映乙型肝炎病毒复制方面的临床应用价值.方法 收集2014年1月至2015年1月经我院确诊为乙型肝炎患者的血清标本248例,采用电化学发光法检测血清学标志物(HBsAg、抗-HBs、HBeAg、抗-HBe和抗-HBc)、酶联免疫吸附试验(ELISA)检测Pre-S1-Ag、实时荧光定量聚合酶链反应(RT-PCR)检测HBV-DNA载量.同时对50例健康对照者也进行相同的检测.结果 248例乙型肝炎患者HBV-DNA、Pre-S1-Ag、HBeAg的阳性率分别为62.5%(155/248)、56.0%(139/248)、36.3%(90/248);Pre-S1-Ag与HBV-DNA存在相关性(P<0.01,r=0.586),Pre-S1-Ag与HBeAg也存在相关性(P<0.01,r=0.459),且Pre-S1-Ag与HBV-DNA的相关性更密切;以乙肝病毒HBV-DNA≥103copies/ml为判断乙肝病毒存在复制的标准,Pre-S1-Ag的灵敏度、特异度、阳性预测值、阴性预测值、阳性似然比、阴性似然比和Youden指数分别为:83.9%、90.3%、0.94、0.77、8.7、0.18、0.74.结论 Pre-S1-Ag与HBeAg相比,Pre-S1-Ag和HBV-DNA有较高的阳性符合率,能更准确地反映HBV的复制情况.

Correlation between pre-S1 antigen and HBV-DNA,HBeAg in hepatitis B patients

Objective To study the correlation between pre-S1 antigen (Pre-S1-Ag) and HBV-DNA, HBeAg in hepatitis B patients, and to evaluate the clinical value of Pre-Sl-Ag in reflecting the replication of hepatitis B virus. Methods Serum samples were collected from 248 patients with hepatitis B infection in our hospital from Jan. 2014 to Jan. 2015. The serological markers (HBsAg, anti-HBs, HBeAg, anti-HBe and anti-HBc) were detected by the electroche-miluminescence immunoassay method, and Pre-S1-Ag was detected by enzyme-linked immunosorbent assay (ELISA). HBV-DNA copies were detected by real-time fluorescence quantitative polymerase chain reaction (RT-PCR). Mean-while, 50 healthy control subjects were also detected. Results The positive rates of Pre-S1-Ag, HBV-DNA, HBeAg were 62.5%(155/248), 56.0%(139/248) and 36.3%(90/248), respectively. Significant correlation was found between Pre-S1-Ag and HBV-DNA (P<0.01, r=0.586), Pre-S1-Ag and HBeAg (P<0.01, r=0.459), as well as between Pre-S1-Ag and HBV-DNA. Taking HBV-DNA≥103 copies/mL as the judgment of HBV replication, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), negative likelihood ratio (NLR) and Youden index of Pre-S1-Ag were 83.9%, 90.3%, 0.94, 0.77, 8.7, 0.18 and 0.74, respective-ly. Conclusion Compared with Pre-S1-Ag and HBeAg, Pre-S1-Ag and HBV have a higher positive coincident rate, and can more accurately reflect the replication of HBV.