PreSlAg、HBeAg和HBV—DNA的对比检测与分析

目的：通过对比检测和分析739份血清中preS1蛋白、HmAg和HBV—DNA的检测阳性率，为临床正确选用实验室指标防治乙型肝炎提供依据。方法：应用ELISA法对739份血清进行PreSlAg和HBV血清标志物检测，并与实时荧光定量PCR检测HBV—DNA结果进行比较。结果：所有739份血清中，PmSlAg阳性率为34．6％（256／739），HmAg阳性率为觚7％（227／739），HBV—DNA阳性率为58.9％（435／739）。227份HBeAg阳性血清中，PreSlAg阳性率55．9％（127／227），HBV-DNA阳性率96．0％（218／227）；512份HBeAg阴性血清中，PreSlAg阳性率25．2％（129／512），HBV—DNA阳性率为42．4％（217／512）。HBeAg、HBV—DNA和PreSl的阳性率有显著差异（P〈0．05），阳性率高低依次为HBV—DNA〉PreSl〉HBeAg；HBeAg阳性血清中PreSlAg（55．9％）阳性率显著高于HmAg阴性血清PreSlAg（25．2％）阳性率（x^2=36．5，P〈0．01）；HBV—DNA阳性血清的PreSlAg检出率58．9％（256／435）显著高于HBV—DNA阴性血清的PreSlAg检出率1＆4％（56／304）（P〈0.01）；PreSl抗原与HBV—DNA阳性符合率为（200／256）7＆1％，阴性符合率为（248／483）51．3％。598份HBeAg阳性血清（阳性率为80．9%，598／739）中HBeAg、PreSl和HBV—DNA阳性数（率）分别是224（37．5%）、253（42．3oA）、417（69．7％）。结论：PreSlAg、HBV—DNA、HBeAg的阳性率有显著性差异（P〈0．05）。作为HBV感染和复制的指标，以检测HBV—DNA最为可靠，而PmSlAg可能较HBeAg更敏感。在HBV感染的不同时期，如何理解和使用上述指标对防治乙型肝炎有重要意义。

Detection of PreSlAg, HBeAg and HBV - DNA and comparison their clinical significance

Objective:To compare the positive rate of HBeAg, Pres1Ag and HBV-DNA in 739 serum samples so as to offer the basis of selecting correctly examination indexes for the prevention and treatment of hepatitis B.Methods:The markers of Pres1Ag and HBV in 739 serum samples were detected by ELISA and the marker of HBV-DNA by real time fluorescence quantitative PCR(FQ PCR).The detected results were compared each other.Results:In all samples,the positive rates of Pres1Ag,HBeAg and HBV -DNA were 34.6%(435/739),30.7%(227/739) and 58.9%(435/739),respectively.In 227 samples with positive HBeAg,the positive rates of Pres1Ag and HBV-DNA were 55.9% and 96.0%,respectively.In 512 samples with negative HBeAg,the positive rates of Pres1Ag and HBV-DNA were 25.2% and 42.4%,respectively.The positive rate of Pres1Ag(58.9%) in samples with positive HBV-DNA was significantly higher than that in the samples with negative HBV-DNA(18.4%,P<0.01).The positive coincidence was 78.1%(200/256) and the negative coincidence was 51.3% between Pres1Ag and HBV-DNA.In 598 serum samples with positive HBsAg(80.9%,598/739),the positive rates of HBeAg,PreS1Ag and HBV-DNA were 37.5%,42.3% and 69.7%.Conclusion:There are significant differences of positive rate among HBeAg,PreS1Ag and HBV-DNA.HBV-DNA is more accurate for the detection of hepatitis B than the other two indexes,but PreS1Ag is more sensitive than HBeAg in judging the infection and replication of HBV.