【摘要】 目的探讨乙型肝炎病毒前S1抗原(Pre-S1)、HBV DNA在乙型肝炎血清标志物模式中的价值及临床意义。方法对3226例乙型肝炎表面抗原(HBsAg)阳性患者血清标本同时进行乙型肝炎病毒(HBV)标志物、Pre-S1的酶联免疫吸附试验(ELISA)检测和HBV DNA的实时荧光定量聚合酶链反应(PCR)检测,并分Pre-S1阳性组与阴性组进行统计学分析。结果Pre-S1阳性组检出HBV DNA的平均含量是(7.34±0.88)拷贝/mL,阴性组是(5.41±1.14)拷贝/mL。两组比较:HBVDNA的检出率(P<0.005)和HBV DNA的含量(P<0.05)差异都有显著性。Pre-S1阳性的乙型肝炎血清标志物模式组中HBV DNA的检出率为77.11%,Pre-S1阴性的乙型肝炎血清标志物模式组中HBV DNA的检出率是29.30%,阳性组检出率较高的3种血清学模式是HBsAg与乙型肝炎e抗原(HBeAg)双阳(模式⑤,100.00%),HBsAg、HBeAg、乙型肝炎核心抗体(HBcAb)三阳(模式①,95.98%),HBsAg、HBeAg、HBeAb、HBcAb四阳(模式③,95.00%);阴性组检出率较高的3种血清学模式是模式⑤(100.00%)、模式③(75.00%)、模式①(63.87%)。结论Pre-S1作为一种新的反映HBV复制状态和传染性的指标,在乙型肝炎血清标志物模式中具有重要意义,其阳性血清标志物模式患者HBV复制活跃,HBV含量高。更多还原

【Abstract】 Objective To investigate the clinical value of Pre-S1 and HBV-DNA in type forecast of HBV markers.Methods Totally 3 266 cases of serum specimens with positive HBsAg were enrolled in the study.HBV markers and Pre-S1 were detected by applying ELISA,and HBV-DNA content was measured with real-time PCR assay in this study.All samples were divided into two groups according to positive or negative Pre-S1 detection result.Results There were statistical differences in the mean value of HBV-DNA(copies/mL)(7.34±0.88 vs 5.41±1.14)and detection rate(77.11% vs 29.30%)between Pre-S1 positive group and Pre-S1 negative group(both P<0.05).The three major serological patterns in Pre-S1 positive group were:HBsAg+HBeAg+(pattern⑤,100.00%), HBsAg+HBeAg+HBcAb+(pattern①,95.98%)and HBsAg+HBeAg+HBeAb+HBcAb+(pattern③,95.00%),and three major serological patterns in Pre-S1 negative group were:pattern⑤(100.00%),③(7.005%)and①(63.87%).Conclusion As a sensitive marker to monitor the replication and transmissibility of hepatitis B virus,Pre-S1 contributes to the forecast of HBV markers;a positive serological pattern is an indication of active HBV replication and high level of HBV.更多还原