前S1抗原在乙型肝炎诊断中的作用

目的：分析乙型肝炎病毒前S1抗原（PreS1）与乙型肝炎病毒（HBV）复制的关系。方法：采用酶联免疫吸附实验（ELISA）方法对364例乙型肝炎不同标志物的患者血清进行PreS1测定并与用荧光定量聚合酶链反应对HBV—DNA进行含量测定，然后做对比分析。结果：364例乙型肝炎患者中，167例HBsAg、HBeAg、抗HBc^＋阳性组中PreS1叶。144例（86．2％），HBVDNA阳性147例（88．0％），这组患者病毒高度复制，PreS1和HBVDNA两者间差异无显著意义，P〉0．05。122例HBsAg、抗HBe、抗HBc阳性组中PreS1^＋38例（31．1%），HBVDNA阳性43例（35．2％），表明HBeAg阴性患者仍有病毒复制，两者间差异无显著意义，P〉0．05。65例HBsAg和抗HBc阳民生组中PreS1^＋17例（26．2％），HBVDNA^＋20例（30．7％），表明病人仍有病毒在复制。10例HBsAg、HBeAg阳性组中PreS1^＋7例（70．0％），HBVDNA＋9例（90．0％），表明病人病毒在复制。结论：乙肝病毒前S1抗原是乙肝病毒在体内复制和传染的可靠指标，特别是在反映HBeAg阴性的乙型肝炎患者是否有病毒复制的诊断中有重要意义。

Role of hepatitis B virus - preS1 antigen in diagnosis of hepatitis B

Objective: To study the role of hepatitis B virus -preB1(PreS1) antigen in detecting the replication of virus. Methods: PreS1 antigen and serological makers of 364 samples were examined by ELISA and fluorescence quantitative PCR(FQ -PCR), the results were compared each other and analyzed. Results: Among 167 samples with positive HBsAg, HBeAg and HbcAb, 144 ones was positive to PreS1 antigen*86.2%) and 147 were positive to HBV DNA(88.0%), which suggested active replication of hepatitis B virus. There was not any significant difference between the positive rates of PreS1 antigen and HBV DNA. Among 122 samples with positive HBsAg, HBeAb and HBcAb, the positive rates of PreS1 antigen and HBV DNA were 31.1%(n=38) and 35.2%(n=43), respectively, which suggested that HBV still replicated in some patients though their HBeAg was negative. Among 65 samples with positive HBsAg and HBc, the positive rates of PreS1 antigen and HBV DNA were 26.2%(n=17) and 30.7%(n=20), respectively, which also suggested that HBV still replicated in some patients. Among 10 samples with positive HBsAg and HBeAg, the positive rates of PreS1 antigen and HBV DNA were 70.0%(n=7) and 90.0%(n=9), respectively. Conclusion: PreS1 antigen is a reliable index that indicates the replication of HBV in the human body, and it has an important role in the diagnosis of HB, especially for those with negative HBeAg.