乙型肝炎患者血清HBV-DNA载量与前S1抗原和e抗原关系探讨  

Study relation between the level of serum HBV-DNA and PreS1 and HBeAg

作　　者：黄学梅[1] 林丁[1] 甘晓协[1] 张达容[1] 

机构地区：[1]重庆市肿瘤医院临检中心,400030

出　　处：《重庆医学》2006年第20期1880-1881,共2页Chongqing medicine

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〈10^3copies／ml150例，其中PreS1阳性81例（54．00％），HBeAg阳性10例（6．67％）；10^3～1065 copies／ml44例，其中PreS1阳性22例（50．00％），HBeAg阳性16例（36．36%）；10^5～10^8 copies／ml 68例，其中PreS1阳性59例（86．76％）．HBeAg阳性43例（63．24％）；〉10^8 copies／ml 10例，其PreS1和HBeAg均为阳性。以HBV—DNA载量10^3copies／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。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 HBcAg 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.

关 键 词：乙型病毒性肝炎 前S1抗原 E抗原 HBV-DNA载量 

分 类 号：R512.62[医药卫生—内科学] R446.112[医药卫生—临床医学]