HBV-pre-C区段变异患者血清前S1抗原检测的临床价值分析

目的探讨HBV-pre-C区段(nt1896)变异阳性患者血清HBV-pre-S1抗原检测的临床价值.方法选取病毒复制为阳性的乙肝血清76份,其中,HBeAg(-)且HBV-pre-C区段(nt1896)变异阳性的46份;HBV-pre-C区段(nt1896)变异阴性的30份;体检正常对照30例.以ELISA法检测其血清乙肝病毒前S1抗原(HBV-pre-S1),同时检测血清中谷氨酸氨基转移酶(ALT)活性.结果HBV-pre-C区段(nt1896)变异阳性血清中82.6%(38/46)HBV-pre-S1检测为阳性,其中92.1%(35/38)伴血清ALT活性异常增高;HBV-pre-C区段(nt1896)变异阴性的血清中83.3%(25/30)HBV-pre-S1检测为阳性,92.0%(23/25)伴血清ALT活性异常增高;正常对照组中HBV-pre-S1检测为阴性,血清ALT活性均正常.HBV-pre-C区段(nt1896)变异阳性组与阴性组,HBV-pre-S1检出率差异无显著性(P=2.1387,P＞0.05),HBV-pre-S1阳性血清中伴ALT异常增高率在两组间差异也无显著性(P=3.4211,P＞0.05).结论当HBV发生基因变异时,HBeAg不能正常表达,血清中HBV-pre-S1抗原的检测可基本避免基因变异的干扰,大致反映病毒基因的复制及活动.

Clinical testing and estimation of HBV-pre-S1 in HBV precore mutant patient

Objective To explore the clinical value about the testing of HBV-pre-S_1 in HBV precore mutant patient. Methods The serum-HBV-pre-S_1 in HBV patient with HBV DNA(+) were tested. It included precore mutant (1896 G-A point mutation) patient 46 samples with HBeAg(-); 30 samples without HBV precore mutant (1896 G-A point mutation) included 20 samples with HBeAg (+) and 10 samples with HBeAg (-) by ELISA, in the same time we tested serum-ALT in all samples. Thirty healthy cases were used to be compared. Results The detective rate of HBV-pre-S_1 in HBV precore mutant (1896 G-A point mutation)(+) groups (82.6%) and that in HBV precore mutant (1896 G-A point mutation) (-) groups (83.3%) had not statistical significance (P=2.1387, P>0.05). The rate of serum ALT pathologyical increased in the sampies with HBV-pre-S_1(+) and HBV precore mutant (1896 G-A point mutation) (+) (92.1%) and another sampies with HBV-pre-S_1 (+) and HBV precore mutant (1896 G-A point mutation) (-) (92.0%) had not statistical significance (P=3.4211, P>0.05). Conclusion HBV precore mutant (1896 G-A point mutation) is able to result in HBeAg(-), the test of serum-HBV-pre-S_1 can avoid with the disturb of this mutant probably, It's value is might represent the reproduction of HBV.