乙型肝炎病毒PreS1蛋白检测对HBV感染的诊断价值

目的研究乙型肝炎病毒前S1蛋白对HBV感染的诊断价值。方法酶联免疫吸附法定性检测乙型肝炎病毒血清标志物(HBV-M)和PreS1蛋白,荧光定量PCR法检测外周血乙肝病毒DNA,电化学发光免疫分析法定量检测外周血HBeAg、HBsAg。结果按13→135→145→15的模式转换次序PreS1阳性率依次为91.84%、85.79%、71.01%、78.82%;PreS1阳性率随HBV-DNA水平升高而升高,对HBV-DNA的Se=0.81、Sp=0.27、kappa=0.1;在各模式中PreS1阴性组和阳性组的HBV-DNA阳性率差异均不存在统计学意义(P>0.05);HBeAg阳性(HBeAg定量>1 U/ml)对于PreS1的OR=4.16,差异具有统计学意义(χMH=4.34);PreS1阳性率随HBsAg定量水平升高而升高。结论外周血PreS1受HBV-M模式、HBV-DNA、HBeAg、HBsAg的影响;在HBV感染的实验室诊断和临床治疗过程中,应结合上述因素对其检测结果作出综合评价。

Diagnostic Value of PreS1 Protein for HBV Infection

Objective To investigate the diagnostic value of PreS1 protein for HBV infection.Methods HBV-M and PreS1 were detected by enzyme-linked immunosorbent assay(ELISA),HBV-DNA by fluorescent quantitative PCR,HBeAg and HBsAg by electro chemiluminescence immunoassay(ECLIA) quantitatively.Results Positive rates of PreS1 were 91.84%,85.79%,71.01%,78.82% respectively in model 13,135,145,15.PreS1 positive rate increased with HBV-DNA level and to HBV-DNA PreS1 had high sensitivity(Se=0.81) but Sp was 0.27,kappa 0.1;moreover no statistical difference existed between PreS1 positive group and negative group in each model.PreS1 positive rate varied with HBeAg and HBsAg level and OR of HBeAg to PreS1 was 4.16.The difference had statistical significance.Positive rate of PreS1 increased with the quantity of HBsAg.Conclusion Four elements including HBV-M model,HBV-DNA,HBeAg and HBsAg had influence on PreS1,which should be considered comprehensively on making an diagnosis and treatment for HBV infection.