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目的:探讨慢性乙型肝炎病毒(HBV)携带者血清前S1抗原(PreS1Ag)、乙肝e抗原(HBeAg)与HBV-DNA的相关性,以了解PreS1Ag联合HBeAg反映HBV复制临床价值。方法:收集390例慢性乙型肝炎患者标本,所有标本均采用酶联免疫吸附法(ELISA)检测HBV-m及PreS1Ag,用实时荧光定量聚合酶链反应(FQ-PCR)检测HBV-DNA。结果:在115例HBV大三阳标志物模式中,HBV-DNA和PreS1Ag的阳性率分别达到了87.8%和90.4%,较所有标志物模式都要高,且差异有统计学意义(P<0.05)。HBeAg、PreS1Ag阳性率都随HBV-DNA载量升高而增高,且不同HBV-DNA载量水平下PreS1Ag与HBeAg检出率间差异均具有统计学差异(P<0.05);但在同一HBV-DNA载量水平下,PreS1Ag比HBeAg增高更明显(P<0.05)。115例PreS1Ag与HBeAg双阳性患者中,HBV-DNA阳性率达到93%;226例PreS1Ag与HBeAg双阴性患者中,HBV-DNA阳性率仅为8.4%。结论:PreS1Ag与HBV-DNA的相关性较HBeAg抗原与HBV-DNA的相关性高。PreS1Ag和HBeAg双阳性的感染者更能敏感反映HBV的复制程度。因此,PreS1Ag与HBeAg联合检测对预测病毒复制情况具有重要的临床意义。
Objective: To investigate the relationship between PreS1Ag, HBeAg and HBV-DNA in chronic hepatitis B virus (HBV) carriers and to find out the clinical value of PreS1Ag combined with HBeAg in HBV replication. Methods: 390 specimens of patients with chronic hepatitis B were collected. HBV-DNA and PreS1Ag were detected by enzyme linked immunosorbent assay (ELISA) and HBV-DNA by real-time fluorescence quantitative polymerase chain reaction (FQ-PCR) Results: The positive rates of HBV-DNA and PreS1Ag in HBV-YS markers were 87.8% and 90.4%, respectively, which were higher than those of all the markers (P <0.05) ). The positive rates of HBeAg and PreS1Ag were all increased with the increase of HBV-DNA load, and there was significant difference between the detection rates of PreS1Ag and HBeAg in different HBV-DNA levels (P <0.05) PreS1Ag increased more significantly than HBeAg at DNA loading level (P <0.05). Among 115 cases of PreS1Ag and HBeAg positive patients, the positive rate of HBV-DNA was 93%. In 226 cases of PreS1Ag and HBeAg double negative patients, the positive rate of HBV-DNA was only 8.4%. Conclusion: The correlation between PreS1Ag and HBV-DNA is higher than that of HBeAg antigen and HBV-DNA. PreS1Ag and HBeAg positive double infection more sensitive to reflect the degree of HBV replication. Therefore, the combined detection of PreS1Ag and HBeAg has important clinical significance in predicting the virus replication.