乙型肝炎病毒前S1抗原与HBVDNA、HBeAg的相关性分析——附178例检测分析

目的：探讨HBV前S1抗原（pre-S1antigen，Pre—S1Ag）与HBVDNA、HBeAg的相关性，并评价Pre—S1鲰的临床应用价值。方法：对178例慢性乙型病毒性肝炎（慢乙肝）患者采用EUSA法检测Pre．S1Ag、HBeAg，采用荧光定量PCR法检测HBVDNA，比较Pre．S1Ag、HBeAg与HBVDNA的诊断符合率，并根据HBVDNA载量分为低复制组、中等复制组及高复制组，分析HBVDNA载量与Pre-S1Ag阳性率的相关性。结果：178例的HBVDNA均为阳性，其中Pre—S1Ag阳性144例（80．9％），Pre—S1Ag阴性34例（19．1％）；HBeAg阳性112例（62．9％），HBeAg阴性66例（37．1％）。Pre—S1Ag、HBeAg与HBVDNA的诊断符合率分别为80．9％、62．9％，上述两诊断符合率比较差异有统计学意义（P〈0．05）。112例HBeAg阳性慢乙肝者中，Pre-S1Ag的阳性率80．4％；66例HBeAg阴性慢乙肝者中，Pre—SlAg阳性率82％。HBV高复制组的Pre-S1Ag阳性率（93％）高于中等复制组（80％）和低复制组（64％），且HBVDNA载量与Pre—S1Ag的阳性率呈正相关（r=0．293，P〈0．01）。结论：Pre．S1Ag与HBVDNA有较好的相关性，在无法开展HBVDNA检测的基层医院，对于HBeAg阴性慢乙肝患者应增加检测Pre-S1Ag，以提高检测的准确度。

Correlation analysis among HBV pre-S1 antigen,HBV DNA and HBeAg.

Objective： To investigate the relationship among HBV pre-S1 antigen （Pre-S1Ag）, HBV DNA and HBeAg, and to evaluate the clinical significance of Pre-S1Ag. Methods：Serum HBeAg and Pre-S1Ag were de- tected by ELISA in 178 patients with chronic Hepatitis B. HBV DNA was tested by quantitative fluorescence PCR technique. The positive concordance rate of HBV DNA （ ＋ ）/Pre-S1Ag（ ＋ ） and HBV DNA（ ＋ ）/HBeAg（ ＋ ） was compared. All patients were divided into three groups according to their HBV DNA levels： low duplication group, medium duplication group and high duplication group. The correlation between HBV DNA levels and Pre- SlAg was analyzed. Results：In 178 patients with HBV DNA（ ＋ ）, Pre-S1Ag positive was 144 cases（80. 9% ） and Pre-S1Ag negative was 34 cases （ 19. 1% ）. For HBeAg, 112 cases （62. 9% ） were positive and 66 cases （37. 1% ） were negative. The positive concordance rate of HBV DNA（ ＋ ）/Pre-S1Ag（ ＋ ） and HBV DNA（ ＋ ）/ HBeAg（ ＋ ） was 80. 9% and 62.9%, respectively, there was statistically significant（P 〈0. 05）. In 112 cases with HBeAg（ ＋ ）, the positive rate of Pre-S1Ag was 80.4%. In 66 HBeAg（ - ） cases, the positive rate of Pre- SlAg was 82%. The positive rate of Pre-S1Ag （93%） in high duplication group was higher than in the medium＇s （80%） and low＇s（64% ）. The level of HBV DNA was significantly related to the positive rate of Pre-S1Ag（r = 0. 293 ,P 〈0.01 ）. Conclusion： There is a better correlation between the Pre-SIAg and HBV DNA. In order to en- hance the examination accuracy, Pre-S1Ag should be measured in chronic Hepatitis B patients with HBeAg（ - ）, if some hospitals are not able to detect HBV DNA.