【摘要】 目的探讨前S1抗原和HBV-DNA与HBV血清标志物之间的关系。方法对1158例慢性乙型肝炎患者用酶联免疫吸附试验(ELISA)检测HBV血清标志物和PreS1,聚合酶链反应(PCR)方法检测HBV-DNA。结果1158例慢性乙型肝炎患者中HBV-DNA总阳性率68.9%,PreS1总阳性率54.8%,有显著性差异(χ2=53.24,P<0.005)。HBV-DNA、PreS1在HBeAg(+)组的阳性率均明显高于HBeAg(-)组(HBV-DNA:χ2=226.24,P<0.005;PreS1:χ2=49.64,P<0.005)。PreS1和HBeAg与HBV-DNA的总符合率分别为56.9%和63.3%,PreS1的敏感性高于HBeAg,但特异性则相反。随着HBV-DNA拷贝数的升高,PreS1和HBeAg的阳性率亦随之升高,HBV-DNA含量低时PreS1的阳性率明显高于HBeAg。结论联合检测HBV血清标志物、PreS1,并动态监测HBV-DNA的含量,在观察慢性乙肝患者HBV复制、疗效时具有重要的临床应用价值。PreS1可作为HBeAg阴性、无条件开展HBV-DNA检测时的补充指标。更多还原

【Abstract】 Objective To study the correlations between preS1 antigen, HBV-DNA and hepatitis B virus (HBV) serum markers in patients with chronic hepatitis B. Methods The HBV markers, preS1 antigen and HBV-DNA were determined using enzyme- linked immunosorbent assay and quantitative PCR in 1158 patients with chronic hepatitis B. Results In these patients, the HBV-DNA positivity rate was 68.9%, significantly higher than preS1 antigen positivity (54.8%, χ2=53.24, P<0.005). The positivity rates of both HBV-DNA and PreS1-antigen were significantly higher in HBeAg-positive patients than in HBeAg-negative patients (P<0.005). The coincident rates of preS1-antigen and HBeAg with HBV-DNA were 56.9% and 63.3%, respectively. PreS1 antigen had higher sensitivity but lower specificity than HBeAg. The detection rates of preS1 antigen and HBeAg increased with the level of HBV-DNA, and preS1 antigen positivity was higher than that of HBeAg in patients with low HBV-DNA levels. Conclusion Detection of HBV serum markers along with preS1 antigen and HBV-DNA may help assess the status of viral replication and therapeutic efficacy in patients with chronic hepatitis B. PreS1 antigen may serve as an auxiliary indicator in HBeAg-negative cases or when HBV-DNA detection is impossible.更多还原