乙型肝炎病毒前S1抗原与病毒DNA检测及相关性研究

目的了解乙型肝炎病毒（HBV）前S1（Pre-S1）抗原在乙肝患者血清中的表达及评判其与HBV复制的关系。方法采用ELISA法检测858例各型乙肝患者血清标志物，以荧光定量PCR法检测HBV DNA，并比较分析Pre-S1抗原、HBeAg与HBV复制的相互关系和临床意义。结果858例各型乙肝患者中，Pre-S1抗原阳性总检出率为30．1％（258／858），HBeAg阳性总检出率为20．7％（178／858），HBV DNA阳性总检出率为43．2％（371／858）。在258例Pre-S1抗原阳性患者中，HBV-DNA阳性检出率为94．1％（243／258），而在371例HBV DNA阳性乙肝患者中，Pre-S1抗原和HBeAg阳性率分别为65．5％（243／371）和45．6％（169／371），两者差异有显著性（P〈0．01）。结论Pre-S1抗原能够比HBeAg更灵敏地反映HBV复制，临床上可作为乙肝患者体内HBV复制的重要标志，但其敏感性不如HBV DNA强。

Determination and study of the relationship between the Pre-S1 antigen and HBV DNA

Objective To investigate the situation of expression of Pre-S1 antigen in serum of chronic hepatitis B patients and the effect of these markers on HBV replication. Methods ELISA was used to analyze these serum markers of HBV in 585 chronic hepatitis B patients who were included in this study. HBV DNA was determined by quantitative PCR assay. The relationship of Pre-S1 antigen, HBeAg and the HBV replication was also analyzed, simultaneously. Results The total positive rate of Pre-S1 antigen in these patients was 30.1%, and the HBeAg was just 20.7%, while the HBV DNA reached 43.2%. The positive rate of HBV DNA reached 94.1% in 258 case patients with Pre-S1 antigen (+). Further, we found that there was a significant difference of positive rate between Pre-S1 antigen and HBeAg in 371 case HBV DNA (+) patients. Conclusion Pre-S1 is more sensitive than HBeAg to reflect the HBV replication in chronic hepatitis B patients, but the sensitivity is not more than HBV DNA. Pre-S1 antigen should be regarded as an important marker for HBV replication in clinical diagnosis and therapy.