HBV外膜大蛋白在判断HBV复制中的价值

目的通过检测慢性乙型肝炎患者血清乙型肝炎病毒（HBV）外膜大蛋白（LP）、DNA、前S1抗原（PreS1）并进行比较分析,探讨血清HBV-LP检测在慢性乙型肝炎中的诊断价值。方法采用酶联免疫吸附试验（ELISA）检测416例慢性乙型肝炎患者乙型肝炎e抗原（HBeAg）、HBV-LP和HBV-PreS1,并应用实时荧光定量聚合酶链反应（PCR）平行检测HBV DNA。按HBeAg阴阳性不同分组,比较HBV-LP、HBV-PreS1及HBV DNA阳性率的差异。结果 416例慢性乙型肝炎患者血清HBV-LP有较高的阳性检出率（76.68%）,与HBV DNA的阳性率（72.60%）差异无统计学意义（P〉0.05）,两者阳性率均高于HBV-PreS1阳性率（36.06%,P〈0.01）;在HBeAg阴、阳性患者中,HBV-LP与HBV DNA的阳性率差异均无统计学意义（P均〉0.05）,均显著高于HBV-PreS1阳性率（P〈0.01）。结论血清HBV-LP水平能反映慢性乙型肝炎患者体内HBV复制程度,其敏感性高于HBV-PreS1,可作为判断HBV复制新的血清学指标。

Significance of HBV-LP in the diagnosis of HBV replication

Objective To investigate the diagnosis significance of hepatitis B virus（HBV）-large surface protein（LP） detection in the diagnosis of chronic hepatitis B by measuring and analyzing comparatively the serum HBV-LP,HBV DNA and HBV pre S1 antigen（PreS1）.Methods Enzyme-linked immunosorbent assay（ELISA） was used to measure hepatitis B e antigen（HBeAg） and the levels of serum HBV-LP and HBV-PreS1,and real-time fluorescence quantitative polymerase chain reaction（PCR） was used to detect HBV DNA in 416 patients with chronic hepatitis B.The patients were classified according to the positivity and negativity of HBeAg,and the positive rate differences of HBV-LP,HBV-PreS1 and HBV DNA were compared and analyzed.Results No significant difference of the positive rates in 416 patients with chronic hepatitis B was found between the HBV-LP（76.68%） and HBV DNA（72.60%,P0.05）.The positive rates of HBV-LP and HBV DNA were significantly higher than that of HBV-PreS1（36.06%,P0.01）.The positive rates of HBV-LP and HBV DNA were not significantly different（P0.05）,and also were significantly higher than that of HBV-PreS1 among various patterns of HBeAg（P0.01）.Conclusions The level of serum HBV-LP can reflect the HBV replication of the chronic hepatitis B patients,and the sensitivity is superior to HBV-PreS1.It may serve as a new index in reflection of HBV replication levels.