乙型肝炎患者血清前S1抗原和HBV DNA与肝功能的关系探讨

目的探讨乙型肝炎病毒前S1抗原(PreS1)及HBV-M和HBV DNA与肝功能检测间的关系。方法对576例血清标本进行PreS1及HBV-M和HBV DNA及丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)同步检测。结果PreS1、HBV DNA阳性率分别为72.05%和61.81%,两者符合率达74.65%;在HBsAg(-)和正常对照组PreS1、HBV DNA均为阴性;在HBsAg、HBeAg与HBsAg、抗-HBe、抗-HBc和HBsAg、抗-HBc三种阳性模式组中,PreS1阳性率(87.25%、55.71%、68.21%)、HBV DNA阳性率(94.02%、29.29%、45.66%)在各组中相互比较差异均有显著性(P均<0.005);PreS1与HBV DNA阳性符合率为92.03%、53.57%、68.21%,差异有显著性(P<0.05);PreS1阳性组和PreS1阴性组ALT、AST异常率相比,差异有显著性(P<0.05)。结论PreS1主要存在于HbsAg阳性携带者中,且与HBeAg、HBV DNA关系密切,是反映HBV复制及传染性的又一血清学指标,同时PreS1阳性还与肝功能损害有关。PreS1联合HBV-M及HBV DNA和肝功能同步检测具有重要的临床意义。

The study on the relevance among HBV markers,HBV DNA and liver function index

Objective To explore the relationship among the serum PreS1 antigen,HBV markers,HBV DNA and ALT/AST in samples with hepatitis B viral infection.Methods PreS1,HBV markers,HBV DNA,ALT and AST in 576 serum samples were detected at the same time and PreS1 in 50 serum samples of control group was detected.Results The positive rates of PreS1 and HBV DNA were 72.05%,61.81%,the coincident rate of results was(74.65)%,while PreS1 and HBV DNA were both negative in HBsAg negative and control group;among the three positive patterns with HBsAg( )/HBeAg( ),HBsAg( )/anti-HBe( )/anti-HBc,HBsAg( )/anti-HBc( ),the positive rates of PreS1(87.25%,55.71%,68.21%) and those of HBV DNA(94.04%,29.29%,45.66%) were significantly different(all P<0.005);between PreS1 positive and negative group,the rates of abnormal ALT and AST had significant differences(all P<0.05).Conclusion The results suggests that PreS1 mainly exists in patients with HBsAg( ),and has close relation with the existance of HBeAg and HBV DNA.So it is an another reliable index to reflect the HBV replication.