慢性乙型肝炎患者血清前S1抗原检测的意义

目的探讨PreS1抗原检测的临床价值。方法采用酶联免疫吸附试验法检测421例慢性乙型肝炎患者血清PreS1抗原和HBV标记物;采用荧光定量PCR法检测HBVDNA。结果在421例慢性乙型肝炎患者中,HBVDNA阳性者367例,其中PreS1Ag阳性者188例(51.2%),HBeAg阳性者119例(32.4%),后两者有显著性差异(P0.01);在高HBVDNA载量(105～107copies/ml和107copies/ml)组患者中,PreS1Ag阳性率(60.2%,60.0%)显著高于HBVDNA阴性组(33.3%)和低载量(103～105copies/ml)组(41.9%,P0.01);但在421例患者中,PreS1Ag阳性率(48.9%)低于HBVDNA(87.2%,P0.01)。结论 PreS1Ag能够较HBeAg更好地反映HBV在体内的复制状态,但尚不能代替HBVDNA的检测。

Diagnostic value of hepatitis B virus PreS1 antigen

Objective To investigate the clinical value of PreS1 antigen detection in the diagnosis of chronic hepatitis B. Methods In 421 chronic hepatitis B patients,the PreS1Ag and HBV markers in serum were detected by ELISA,and HBV DNA by fluorescence quantitative PCR. Result The positive rate of PreS1Ag（51.2%） was higher than HBeAg（32.4%）in 367 HBV DNA positive chronic hepatitis B patients（P0.01）;the positive rates of PreS1Ag in high （105～107 copies/ml and107 copies/ml,60.2% and 60.0%） were higher than in low serum HBV DNA load（103～105 copies/ml,41.9%） and in negative group（33.3%,P0.01）;But in 421 patients,the positive rate of PreS1Ag（48.9%） was lower than HBV DNA（87.2%,P0.01）. Conclusion PreS1Ag is more sensitive than HBeAg to reflect the HBV replication in chronic hepatitis B patients,but can’t replace the detection of HBV DNA.