前S1抗原检测在乙型肝炎诊疗中的应用

目的 进一步探讨前S1抗原（PreS1Ag）测定在乙型肝炎诊断疗效和预后等方面的应用价值：方法 用ELISA法检测218例HBsAg阳性的急、慢性乙型肝炎患者的PreS1Ag和血清标志物（HBVM），同时用荧光定量PCR法测定HBVDNA，并对其中20例经拉米夫定治疗的急性患者进行动态观察。结果 HBeAg阳性组，PreS1Ag阳性率为87．2％，HBeAb阳性组为59.8％，HBeAg、HBeAb均阴性组PreS1Ag阳性率为79．7％，PreS1Ag与HBVDNA检测结果一致：结论 PreS1Ag的测定可动态观察乙刊肝炎病毒复制情况，可作为临床常规检测项目，是对乙肝病毒前C区突变时HBeAg的补充，在乙型肝炎的诊疗中有很大的应用价值。

Application of Measuring Pre- SlAg in Diagnosis and Treatment of Hepatitis B

Objective To further explore the significance of measuring Pre-S1-antigen (Pre-S1Ag) in dingnosis, treatment and prognosis of hepatitis B. Methods Serum Pre-S1Ag and hepatitis B virus markers (HBVM) were determined in 218 HBsAg positive patients with acute and/or chronic hepatitis B by ELISA, and also the HBVDNA by fluorescent quantitative PCR method, and keep dynamic observation on 20 acute patients treated with Lamivudine. Results Pre-S1Ag positive rate of patients with HBeAg positive was 87.2%, and HBeAb positive patients were 59.8%. The patients with both HBeAg and HBeAb negative were 79.7%. Pre-S1Ag and HBVDNA showed no difference. Conclusion Determination of Pre-S1Ag dynamically monitoring the replication status of hepatitis B virus, can be adopted as a clinical routine, which is supplementary for HBeAg when hepatitis B virus precore mutants emerged, which is useful in diagnosis and management of (hepatitis) B.