乙型肝炎病毒外膜大蛋白检测对判断病毒复制的临床意义

目的探讨血清病毒外膜大蛋白(LHBs)与乙型肝炎病毒(HBV)感染和复制的相关性。方法检测282例乙型肝炎患者和30名健康对照者血清HBV DNA载量、LHBs和乙型肝炎e抗原(HBeAg)。以HBV DNA载量为标准,对LHBs和HBeAg进行对比分析。结果 HBV DNA载量<103拷贝/mL的107例乙型肝炎患者中LHBs阳性9例(8.41%),HBeAg阳性8例(7.48%);LHBs、HBeAg与HBV DNA载量相同等级的线性相关系数分别为0.972 1和0.837 0(P<0.01、P<0.05);LHBs与HBeAg诊断HBV感染的敏感性分别为92.57%、62.35%,特异性分别为82.52%、77.17%,阳性预测值分别为77.43%、64.08%,阴性预测值分别为59.18%、51.22%,准确率分别为97.05%、89.16%。结论 LHBs能较好地反映HBV复制情况,对乙型肝炎患者进行LHBs、HBV DNA及HBeAg联合检测将有助于疾病的诊断、疗效观察及预后判断。

Clinical significance of hepatitis B virus large envelope protein detection for judging HBV replication

Objective To investigate the correlation of serum hepatitis B virus（HBV） large envelope protein（LHBs） with HBV infection and replication.Methods Serum HBV DNA load,LHBs and hepatitis B e antigen（HBeAg） of 282 patients with hepatitis B and 30 healthy controls were detected.LHBs was compared with HBeAg basing on HBV DNA load.Results Among 107 patients whose serum HBV DNA loads were 103 copies/mL,9（8.41%） patients were LHBs positive,and 8（7.48%） patients were HBeAg positive.The linear correlation coefficients of LHBs and HBeAg with the scale of HBV DNA load were 0.972 1 and 0.837 0 respectively（P0.01,P0.05）.To diagnose HBV infection,the sensitivities,specificities,positive predictive values,negative predictive values and accuracies of LHBs were 92.57%,82.52%,77.43%,59.18% and 97.05%,respectively,and the values of HBeAg were 62.35%,77.17%,64.08%,51.22% and 89.16%,respectively.Conclusions LHBs is a good index to reflect the situation of HBV replication.The combined determination of LHBs,HBV DNA and HBeAg of hepatitis B patients contributes to the clinical diagnosis,therapeutic effect monitoring and prognosis evaluation.