【摘要】 目的探讨乙型肝炎患者血清病毒DNA(HBV-DNA)载量与前S1抗原(PreS1)、e抗原(HBeAg)的关系;评价PreS1的临床检测意义。方法30例健康对照者血清和272例未经抗病毒治疗的乙型肝炎患者血清,同时采用实时荧光定量PCR法测定HBV-DNA载量、ELISA法检测PreS1和HBeAg。结果健康对照HBV-DNA载量、PreS1和HBeAg均阴性。乙肝患者血清HBV-DNA<103copies/ml 150例,其中PreS1阳性81例(54.00%),HBeAg阳性10例(6.67%);103~105copies/ml 44例,其中PreS1阳性22例(50.00%),HBeAg阳性16例(36.36%);105~108copies/ml 68例,其中PreS1阳性59例(86.76%),HBeAg阳性43例(63.24%);>108copies/ml 10例,其PreS1和HBeAg均为阳性。以HBV-DNA载量103copies/ml为切割值,则PreS1和HBeAg的敏感性分别为74.59%、56.56%,特异性分别为46.00%、93.33%,阳性预测值分别为52.91%、87.34%,阴性预测值分别为69.00%、72.54%,准确率分别为58.82%、76.84%。结论随着HBV-DNA载量的升高,PreS1和HBeAg的检出率大幅提高;虽然PreS1判断HBV复制的敏感性高于HBeAg,但其特异性、阳性预测值、阴性预测值、准确率均低于HBeAg。更多还原

【Abstract】 Objective To study the relation between the level of serum HBV-DNA and PreS1 and HBeAg and to evaluate the clinical significance of PreS1.Methods Thirty healthy controls and 272 patients with chronic hepatitis B never treated with anti-viral therapy were selected.Serum level of HBV-DNA was determined by real-time fluorescence quantity PCR.Serum PreS1 and HBeAg were determined by ELISA.Results Serum HBV-DNA,PreS1 and HBeAg of healthy controls were all negative.Among 150 patients with serum level of HBV-DNA<10~3 copies/ml PreS1 of 81 patients(54.00%) was positive and HBeAg of 10 patients(6.67%) was positive.Among 44 patients with serum level of HBV-DNA 10~3-5 copies/ml PreS1 of 22 patients(50.00%) was positive and HBeAg of 16 patients(36.36%) was positive.Among 68 patients with serum level of HBV-DNA 10~5-8 copies/ml PreS1 of 59 patients(86.76%) was positive and HBeAg of 43 patients(63.24) was positive.Among 10 patients with serum level of HBV-DNA>10~8 copies/ml PreS1 and HBeAg of all patients were positive.If the level of HBV-DNA 10~3 copies/ml was suggested as cut-off value,the sensitivities of PreS1 and HBeAg were 74.59% and 56.56%,specificities were 46.00% and 93.33%,positive predict values were 52.91% and 87.34%,negative predict values were 69.00% and 72.54%,accuracy rates were 58.82% and 76.84% respectively.Conclusion The positive rates of PreS1 and HBeAg ignificantly increase as the level of HBV-DNA rises.Although the sensitivity of PreS1 is higher than that of HBeAg the specificity,positive predict value,negative predict value and accuracy rate are all lower than that of HBeAg.更多还原