乙型肝炎病毒前S1蛋白检测的临床价值

目的分析乙型肝炎前S1蛋白(Pre-S1)与HBeAg及HBV-DNA的相关性,探讨Pre-S1蛋白在诊断乙型肝炎病毒复制中的价值。方法收集该院住院慢性乙型肝炎患者血清99例,检测其Pre-S1蛋白、HBV标志物与HBV-DNA定量。结果 HBsAg、HBeAg、HBcAb阳性者28例,HBV-DNA与Pre-S1蛋白的检出率均高达90.0%以上。HBsAg、HBeAb和HBcAb阳性者63例,HBV-DNA与Pre-S1蛋白的检出率分别为82.5%和69.8%;HBsAg和HBcAb阳性者8例,HBV-DNA与Pre-S1蛋白的检出率均为87.5%,说明部分HBeAg阴性患者仍有病毒复制,以乙型肝炎病毒HBV-DNA定量大于或等于5.0×102copy/mL为判断乙型肝炎病毒存在的标准,HBV-DNA与Pre-S1蛋白的阳性检出率比较差异无统计学意义(P>0.05),而HBV-DNA与HBeAg的阳性检出率比较差异有统计学意义(P<0.01)。结论 Pre-S1是诊断及判断乙型肝炎病毒复制的非常有价值的血清学参考指标。

The contrast study of Pre-SI protein,HBV-DNA and HBeAg in diagnosing viral replication in patients with chronic hepatitis B

Objective To determine the role of Pre-S1protein in diagnosing viral replication in patients with chronic hepatitis B.Methods 99consecutive patients with chronic hepatitis B were included in the study,Serial serum samples were studied with the quantitative determination of HBV-DNA by aquantitative PCR assay,determination of Pre-S1protein by ELISA.Results The positive rates of HBV-DNA and Pre-S1protein in patients with HBsAg HBeAg HBcAb(+)both were more 90.0%.The positive rates of HBV-DNA and Pre-SI protein in patients with HBsAg HBeAb HBcAb(+)were 82.5%and 69.8%,respectively.The positive rates of HBV-DNA and Pre-S1protein in patients with HBsAg HBcAb(+)both were 87.5%.It represented some patients with HBeAg(一)HBeAb(+/一)still had viral replication.HBV-DNA≥5.0×102 copy/mL as positive criteria for diagnosing viral replication,the positive rate of HBeAg,Pre-S1were 31.4%(27/86),89.5%(77/86)in patients with HBV-DNA.Conclusion It showed that Pre-S 1was more sensitive than HBeAg in diagnosing viral replication in patients with chronic hepatitis B.