乙型肝炎病毒pre-S1Ag、pre-S2Ag、HBV-DNA、HBV-M的临床比较

目的 探讨乙型肝炎病毒pre-S1Ag、pre-S2Ag、HBV-DNA、HBV-M的相关性及其临床意义.方法 HBV-DNA采用荧光定量PCR法;HBV-M及pre-S1Ag、pre-S2Ag采用ELISA法,检测96例HBV-DNA阳性感染者血清中pre-S1Ag、pre-S2Ag、HBV-M,同时以30例HBV-M全阴性的健康体检者血清作为对照,并对结果进行统计学分析.结果 96例HBV-DNA阳性患者中HBsAg、HBeAg、HBcAb阳性检出率为64.6%;HBsAg、HBeAb、HBcAb阳性检出率为20.8%;HBsAg、HBcAb阳性检出率为14.6%;pre-S1Ag在96例HBV-DNA阳性标本中检出率为70.8%;pre-S2Ag检出率为79.2%;均明显高于HBeAg的阳性率64.6%,30例对照中未检测出pre-S1Ag、pre-S2Ag及HBV-DNA.结论 HBeAg、HBV-DNA、pre-S1Ag、pre-S2Ag之间具有一定的关联性.pre-S1Ag和pre-S2Ag均较HBeAg敏感.pre-S1Ag与pre-S2Ag的检出率差异无显著性,ELISA检测HBV-M、pre-S2Ag及pre-S1Ag只是表型指标,只能提供HBV感染的间接证据.而HBV-DNA的检测是HBV感染与否的直接证据.HBV-M、pre-S1Ag、pre-S2Ag、HBV-DNA的检测各自有其独特的临床意义.应用pre-S1Ag、pre-S2Ag、HBV-DNA及HBV-M进行联合检测,对HBV感染的早期诊断,了解HBV复制、转归及监测疗效和预后有重要的意义.

Study of the relationship among HBV pre-S1 antigen,HBV pre-S2 antigen,HBV-DNA and HBV markers

Objective To study the relationship among HBV pre-S1 antigen,HBV pre-S2 antigen,HBV-DNA and HBV markers. Methods Contents of HBV-DNA were determined by fluorescence quantitative PCR;HBV-M,HBV pre-S1 antigen and HBV pre-S2 antigen by ELISA in 96 serum samples. Results Among 96 cases of HBV-DNA positive the rate of HBsAg,HBeAg and HBcAb positive was 64. 6%. HBsAg,HBeAb and HBcAb positive was 20. 80/00. HBsAg and HP, cAb positive was 14.6% respectively. The positive rate of the Pre-S1 antigen was 70. 8% and Pre-S2 antigen was 79.2%. The positive rate of Pre-S1 antigen and Pre-S2 antigen was higher than HBeAg respectively,and no positive results in the control group. Conclusion There were close relationships among HBeAg,HBV-DNA,HBV pre-S1 antigen and HBV pre-S2 antigen. HBV pre-Sl antigen and HBV pre-S2 antigen were more sensitive than HBeAg. HBV-M,Pre-S1 antigen and Pre-S2 antigen detected by ELISA only had external indication and indirect evi- dence of HBV infection while the detection of HBV-DNA by FQ-PCR had direct evidence of HBV infection. Detection of Pre-S1 antigen,Pre-S2 antigen ,HBV-DNA and HBV-M had their unique clinical significance. There should be more clinical significance by testing HBV pre-Sl antigen ,HBV pre-S2 antigen ,HBV-DNA and HBV-M together in diagnosing infection of HBV and analyzing situation of reproduction of HBV and observing the curative effect and prognosis of the hepatitis.