前S1蛋白在乙型肝炎的诊断及预后判断中的临床价值  

The clinical value of Pre S_1 Protein in diagnosis and prognosis of hepatitis B

作　　者：江浪进[1] 李云慧[1] 刘政[1] 

机构地区：[1]沈阳军区医学检验中心,辽宁沈阳110003

出　　处：《中国实验诊断学》2006年第11期1296-1299,共4页Chinese Journal of Laboratory Diagnosis

摘　　要：目的探讨前S1蛋白(PreS1)在乙型肝炎诊断及其预后判断中的临床意义。方法收集乙型肝炎患者血清共197例,检测其HBV-DNA,PreS1,HBV血清标志物,ALT和AST。结果在携带不同HBV血清标志物的各组患者中,PreS1与HBV-DNA的检出率较一致。在不同临床类型乙型肝炎患者中,PreS1与HBV-DNA的检出率高度符合,PreS1的阳性率较HBeAg高。以HBV-DNA定量>5×102拷贝/ml为阳性诊断标准,PreS1与HBV-DNA的检出率无显著性差异(P>0.05);HBeAg与HBV-DNA的检出率有显著性差异(P<0.001)。142例HBeAg阴性者中HBV-DNA与PreS1的检出率分别为57.7%,56.3%,两者无显著性差异(P>0.05),说明部分患者仍存在着病毒复制。PreS1阳性与阴性患者的转氨酶水平有显著性差异(P<0.05),说明PreS1阳性患者较阴性患者肝组织损伤严重。结论PreS1较HBeAg更敏感地反映HBV的复制情况,特别对HBV病毒是否发生基因变异是主要的观察指标;在急性乙型肝炎患者中,PreS1阴转越早,预后越好。Objective To discuss the clinical meaning of PreS1 Protein in hepatitis B diagnosis and prognosis.Methods Blood samples of 197 hepatitis B patients were included in the study for determination of HBV-DNA,PreS1 Protein, HBV serum models,ALT and AST. Results In each group of hepatitis B patients with different serum models,the positive rates of PreS1 and HBV-DNA were of one accord. In diverse clinical types of hepatitis B cases, tire results of PreS1 and HBV-DNA detection coincided gready,and the positive rates of PreS1 were higher than that of HBeAg. HBV-DNA 〉 5 × 10^2 copies/ml as positive criteria for diagnosis viral replication, the positive rates between PreS1 and HBV-DNA had no visible difference in statistics（ P 〉 0.05）, while the positive rates between HBeAg and HBV-DNA had obvious difference in statistics（ P 〈 0.001）. The positive rates of HBV-DNA and PreS1 in 142 patients with HBeAg（ - ） were 57.7 %, 56.3 % （ P 〉 0.05）, respectively. It represented that some patients still had viral re,cation. There was obvious difference in statistics in the level of tranferase between patients with PieS1 （ ＋ ） and PreSl （ - ） （ P 〈 0.05）. This indicated that tile injury of hepateeytes in tile patients with PreSl （ ＋ ） was more serious than the patients with PreS1（ - ）. Conclusion It showed that PreS1 was more sensitive than HBeAg in diagnosising viral replication in patients with hepatitis B,and it was a valuable noun for recognlsing viral replication after variation occuring in HBV. In acute hepatitis B patients, the earlier PreS1 became negative, the better prognosis of disease.

关 键 词：前S1蛋白 乙型肝炎E抗原 病毒复制 

分 类 号：R512.62[医药卫生—内科学]