【摘要】 目的:探讨HBV前S1抗原(pre-S1antigen,Pre-S1Ag)与HBV DNA、HBeAg的相关性,并评价Pre-S1Ag的临床应用价值。方法:对178例慢性乙型病毒性肝炎(慢乙肝)患者采用ELISA法检测Pre-S1Ag、HBeAg,采用荧光定量PCR法检测HBV DNA,比较Pre-S1Ag、HBeAg与HBV DNA的诊断符合率,并根据HBV DNA载量分为低复制组、中等复制组及高复制组,分析HBV DNA载量与Pre-S1Ag阳性率的相关性。结果:178例的HBVDNA均为阳性,其中Pre-S1Ag阳性144例(80.9%),Pre-S1Ag阴性34例(19.1%);HBeAg阳性112例(62.9%),HBeAg阴性66例(37.1%)。Pre-S1Ag、HBeAg与HBV DNA的诊断符合率分别为80.9%、62.9%,上述两诊断符合率比较差异有统计学意义(P<0.05)。112例HBeAg阳性慢乙肝者中,Pre-S1Ag的阳性率80.4%;66例HBeAg阴性慢乙肝者中,Pre-S1Ag阳性率82%。HBV高复制组的Pre-S1Ag阳性率(93%)高于中等复制组(80%)和低复制组(64%),且HBV DNA载量与Pre-S1Ag的阳性率呈正相关(r=0.293,P<0.01)。结论:Pre-S1Ag与HBV DNA有较好的相关性,在无法开展HBV DNA检测的基层医院,对于HBeAg阴性慢乙肝患者应增加检测Pre-S1Ag,以提高检测的准确度。更多还原

【Abstract】 Objective:To investigate the relationship among HBV pre-S1 antigen(Pre-S1Ag),HBV DNA and HBeAg,and to evaluate the clinical significance of Pre-S1Ag.Methods:Serum HBeAg and Pre-S1Ag were detected by ELISA in 178 patients with chronic Hepatitis B.HBV DNA was tested by quantitative fluorescence PCR technique.The positive concordance rate of HBV DNA(+)/Pre-S1Ag(+)and HBV DNA(+)/HBeAg(+)was compared.All patients were divided into three groups according to their HBV DNA levels:low duplication group,medium duplication group and high duplication group.The correlation between HBV DNA levels and Pre-S1Ag was analyzed.Results:In 178 patients with HBV DNA(+),Pre-S1Ag positive was 144 cases(80.9%)and Pre-S1Ag negative was 34 cases(19.1%).For HBeAg,112 cases(62.9%)were positive and 66 cases(37.1%)were negative.The positive concordance rate of HBV DNA(+)/Pre-S1Ag(+)and HBV DNA(+)/HBeAg(+)was 80.9% and 62.9%,respectively,there was statistically significant(P<0.05).In 112 cases with HBeAg(+),the positive rate of Pre-S1Ag was 80.4%.In 66 HBeAg(-)cases,the positive rate of Pre-S1Ag was 82%.The positive rate of Pre-S1Ag(93%)in high duplication group was higher than in the medium’s(80%)and low’s(64%).The level of HBV DNA was significantly related to the positive rate of Pre-S1Ag(r = 0.293,P<0.01).Conclusion:There is a better correlation between the Pre-S1Ag and HBV DNA.In order to enhance the examination accuracy,Pre-S1Ag should be measured in chronic Hepatitis B patients with HBeAg(-),if some hospitals are not able to detect HBV DNA.更多还原