乙肝患者HBV前S1抗原与HBV-DNA相关性探讨  

Correlation between Pre-S1 Ag and HBV-DNA of patients with hepatitis B

作　　者：黄志伟[1] 沓世念[1] 李国虹[1] 沈均南[1] 黄伟建[1] 陈其铭[1] 

机构地区：[1]肇庆市第二人民医院检验科,广东肇庆526000

出　　处：《海南医学院学报》2011年第2期190-192,196,共4页Journal of Hainan Medical University

基　　金：肇庆市科技局(市级)科技创新立项科研项目(2006E214)~~

摘　　要：目的:探讨乙肝病毒(HBV)前S1抗原(Pre-S1Ag)与e抗原(HBeAg)、HBV-DNA含量的相关性,以评价Pre-S1Ag检测在乙型肝炎诊疗中的价值。方法:临床采集乙肝表面抗原阳性标本315例,以ELISA法检测Pre-S1Ag和HBeAg,实时荧光定量PCR(FQ-PCR)法检测HBV-DNA含量,并分析Pre-S1Ag、HBeAg和HBV-DNA的关系。结果:Pre-S1Ag与HBeAg、HBV-DNA之间存在关联性(χ2分别为85.2、159.22,P<0.01)。HBeAg阴性组(e抗体为阳性)Pre-S1Ag的阳性率为37.0%,HBV-DNA的阳性率为43.2%。HBV-DNA阳性(≥500copies/mL)患者Pre-S1Ag阳性率为84.2%,HBeAg阳性率为52.6%,差异有统计学意义(P<0.01),乙肝患者Pre-S1Ag阳性率随HBV-DNA含量的增加而增加。Pre-S1Ag灵敏度、准确度、优势比(84.2%、85.7%、39.1)优于HBeAg(52.6%、69.2%、18.7),特异度、阳性预测值、阳性似然比相近(88.0%vs 94.4%,91.4%vs 93.4%,7.01 vs9.39)。结论:Pre-S1Ag较HBe Ag能更敏感、更准确地反映HBV复制情况,与HBV-DNA的相关程度更高,在乙型肝炎诊疗中有较高价值。Objective： To explore the relationship among Pre-S1Ag,HBeAg and HBV-DNA of hepatitis B virus（HBV）,and to evaluate the application of Pre-S1 in diagnosis and treatment.Methods： A total of 315 cases with positive HBsAg were selected.Pre-S1 Ag,and HBeAg were determined by ELISA,while the level of HBV-DNA was measured by RT-PCR.And the relationship among Pre-S1Ag,HBeAg and HBV-DNA was analyzed.Results： Pre-S1Ag was associated with HBeAg and HBV-DNA（χ2=85.2 and 159.22,respectively,P〈0.01）. The positive rate of Pre SlAg was 37.0%, and the positive rate of HBV-DNA was 43.2% in HBeAg negative group; while in HBV-DNA positive patients （≥500 copies/ mid, 84.20..4o had the positive rate of Pre-S1Ag, 52.6% had the positive rate of HBeAg. There was signif- icant difference between two groups （P〈0. 01）, and the positive rate of Pre-S1Ag increased as HBV- DNA. The sensitivity, accuracy, and odds ratio of Pre-SIAg were higher than those of HBeAg （4.2% VS 52.6%, 85.7% VS 69.2%, 39.1 VS 18.7）; while specify, positive predictive value and positive likelihood ratio were similar （88.0%VS 94.4% ,91.4% VS 93.40%,7.01 VS 9.39）. Conclusions： Pre-S1Ag is more sensitive and accurate in reflecting the duplication of HBV, and has higher correlativity with HBV DNA. It is valuable in diagnosis and treatment of hepatitis B.

关 键 词：PRE-S1抗原 HBEAG HBV-DNA 

分 类 号：R512.62[医药卫生—内科学]