乙型肝炎病毒前S1抗原与HBV-M和HBV-DNA及肝功能的相关性分析  

Correlations of hepatitis B virus preS1-antigen with HBV-DNA,HBV-markers and liver function in patients with hepatitis B

作　　者：尹幼明[1] 黄景明[1] 谢服役[2] 

机构地区：[1]宁波天一职业技术学院,浙江宁波315104 [2]浙江省宁波市医疗中心李惠利医院,浙江宁波315040

出　　处：《中国卫生检验杂志》2009年第6期1361-1362,1382,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的:探讨乙型肝炎患者HBV前S1抗原(preS1-Ag)与HBV血清标志物(HBV-M)、HBV-DNA及肝功能之间的相关性,判断HBVpreS1-Ag的临床应用价值。方法:用ELISA法对346例乙型肝炎患者(乙型肝炎组)和60例健康者(对照组)进行HBV-M及HBVpreS1-Ag检测。采用荧光定量PCR法检测HBV-DNA,同时检测丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)。用Kappa一致性检测分析HBV-DNA与HBVpreS1-Ag和HBeAg的关系。结果:136例HBeAg阳性和HBsAg阳性患者,HBVpreS1-Ag的阳性率为85.3%,210例HBeAg阴性和HBsAg阳性患者,HB-VpreS1-Ag的阳性率为42.9%,差异具有显著性意义(2χ=61.71,Ρ<0.01)。HBV-DNA与HBVpreS1-Ag一致性较好(Kappa=0.785);HBV-DNA与HBeAg一致性较差(Kappa=0.316)。206例HBVpreS1-Ag阳性患者血清ALT≥60 U/L者占70.4%,ALT≥45 U/L者占73.3%;而140例HBVpreS1-Ag阴性患者ALT≥60 U/L仅29.3%,ALT≥45 U/L者仅34.4%。结论:HBVpreS1-Ag与HBeAg之间具有高度相关性,HBV preS1-Ag与HBV-DNA有较好的一致性,HBVpreS1-Ag(+)与肝功能损害密切相关,故HBVpreS1-Ag可作为判断HBV感染与复制的一项重要检测指标,也可作为判断肝功能的重要指标。Objective：To investigate the correlations of hepatitis B virus （HBV） preS1 - antigen（ preS1 - Ag） with HBV - DNA, HBV - markers（ HBV - M ） and liver function in patients with hepatitis B. Methods ： The HBV - M, HBVpreS1 - Ag and HBV- DNA were determined respectively by ELISA and PCR in 346 patients with hepatitis B and 60 healthy persons. Simultaneously, the ALT and AST were tested. The concordances among HBV - DNA with HBVpreS1 - Ag and HBeAg were analyzed by Kappa method. Results ：The positive rate of HBVpreSI -Ag in 136 patients with HBsAg（ ＋ ） and HBeAg（ ＋ ） was 85. 3%, the positive rate of HBVpreS1 - Ag in 210 patierlts with HBsAg（ ＋ ） and HBeAg（ - ） was 42. 9% ; the difference was significantly （χ^2= 61.71 ,P 〈 0.01 ）. The concordance of HBVpreS1 - Ag with HBV - DNA was better （ Kappa = 0. 785 ）. The concordance of HBeAg with HBV - DNA was not better（ Kappa = 0. 316）. In the 206 HBVpreS1 - Ag（ ＋ ） patients, there was 70. 4% patients＇ ALTo〉60 U/L in the serum, and 73.3% patients＇ AST I〉45 U/L, respectively. While, in the 140 HB- VpreS1 - Ag （ - ） patients, there was only 29. 3% patients＇ ALTo〉60 U/L in the serum, and 4. 3% patients＇ AST≥45 U/L,respectively. Conclusion ：There is a high correlation between HBVpreS1 - Ag and HBeAg. HBVpreS1 - Ag has a better concordance with HBV - DNA. HBVpreS1 - Ag（ ＋ ） is consanguineous correlation with the damage of liver function. Therefore , HBV preS1 - Ag is a good index to reflect the HBV infection and replication, as well as liver function.

关 键 词：HBV前S1抗原 HBV血清标志物 HBV-DNA 肝功能 

分 类 号：R446.61[医药卫生—诊断学]