核苷类似物干预下乙型肝炎病毒前S抗原消长与DNA复制水平的关系  

Analysis of the correlation between the pre-S1 antigen, pre-S2 antigen and DNA of hepatitis B virus in the serum of chronic hepatitis B patients undergoing nucleoside analogue therapy

作　　者：谭朝霞[1] 谭文婷[1] 汤影子[1] 但芸婕[1] 邓国宏[1] 

机构地区：[1]第三军医大学西南医院全军感染病研究所,重庆 400038

出　　处：《中华肝脏病杂志》2009年第2期91-94,共4页Chinese Journal of Hepatology

基　　金：国家自然科学基金（30671850）;教育部“新世纪优秀人才支持计划”（教技函[2007]70号）

摘　　要：目的监测核苷类似物干预下HBV前S1抗原（PreS1）、前S2抗原（PreS2）的动态变化，探讨PreS1、PreS2与HBVDNA复制水平的相关性。方法选取拉米夫定治疗有效应答后出现病毒学反跳的慢性乙型肝炎患者12例，以及持续5年阿德福韦酯抗病毒治疗的慢性乙型肝炎患者20例，动态监测PreS1、PreS2及其他HBV标志物。根据不同资料分别选择t检验、x^2检验、线性相关与回归分析或方差分析。结果12例拉米夫定治疗的患者，在HBV DNA发生剧烈变化的4个时间点，均未观察到PreS1、PreS2滴度随HBVDNA复制水平的一致变化；20例阿德福韦酯治疗的患者中，仅1例患者PreS1、PreS2随HBVDNA和HBeAg一起阴转，其余均无显著变化；采用不等距重复测量设计方差分析绘制变化趋势轮廓图，未观察到PreS1、PreS2滴度随HBVDNA水平一致的变化趋势。结论在核苷类似物干预下PreS1、PreS2滴度不能反映HBV DNA复制水平以及HBeAg的血清学转换。Objective To investigate the dynamic correlation between pre-S 1 antigen, pre-S2 antigen and HBV DNA in the serum of chronic hepatitis B （CHB） patients undergoing nucleoside analogue therapy. Methods 12 CHB patients with transient virological response after lamivudine treatment, and 20 patients treated with adefovir for 5 years were recruited in this study. Serum samples were collected at four time points when HBV DNA fluctuated shalply during lamivudine treatment, and at 0, 8, 12, 28, 52, 104, 156, 208, 260 weeks following adefovir treatment. HBV DNA was quantified by real-time PCR, pre-S1 and pre-S2 antigens were detected by ELISA. Results The titers of pre-S 1 and pre-52 antigens were not correlateta with the HBV DNA level in the serum of lamivudine treated patients. Only in one case of the adfovir treated patients, the decrease of pre-S 1 and pre-S2 antigens was in parallel with the decrease of HBV DNA. Linear regression analysis indicated that neither pre-S 1 antigen nor pre-S2 antigen was correlated with HBV DNA in the serum of lamivudine or adfovir treated patients （P 〉 0.05）. Conclusion Our results indicate that the titers of pre-S1 and pre-S2 antigens are not correlated with the serum HBV DNA in CHB patients undergoing nucleoside analogue therapy. Neither pre-S 1 nor pre-S2 is a good predictor for the outcome of nucleoside analogue treatment.

关 键 词：肝炎病毒 乙型 DNA 肝炎病毒 乙型 前S1抗原 前S2抗原 核苷类似物 

分 类 号：R51[医药卫生—内科学]