乙型肝炎病毒外膜大蛋白与病毒复制及肝脏受损的相关性  

Clinical Significance of Hepatitis B Virus Large Surface Protein and Its Correlation with Virus Replication and Liver Impairment

作　　者：曹军皓[1] 黄前川[1] 

机构地区：[1]广州军区武汉总医院检验科,武汉430070

出　　处：《现代检验医学杂志》2012年第3期148-150,共3页Journal of Modern Laboratory Medicine

摘　　要：目的探讨乙型肝炎患者血清中乙型肝炎病毒外膜大蛋白（hepatitis B virus large surface protein，LHBs）与病毒复制及肝脏受损程度的相关性。方法随机选取武汉总医院2011年3月～6月乙肝患者血清标本192例，分别采用酶联免疫吸附实验（ELISA）检测LHBs，乙型肝炎病毒前S1抗原（PreS1-Ag），化学发光方法定量检测乙型肝炎病毒血清学模式，实时荧光定量PCR方法检测血清HBV-DNA，全自动生化分析仪检测血清谷氨酸氨基转移酶（ALT）。按乙型肝炎病毒e抗原阴阳性不同分组，比较LHBs，HBV-DNA及PreS1-Ag阳性率差异，同时分析LHBs含量与HBsAg，HBV-DNA及ALT水平的相关性。结果HBeAg阳性乙肝患者血清中，LHBs的阳性率与HBV-DNA阳性率差异无统计学意义（χ^2=0．32，P〉0．05），LHBs的阳性率与PreS1-Ag阳性率差异有统计学意义（χ^2=23．44，P〈0．05）；HBeAg阴性乙肝患者血清中，LHBs的阳性率与HBV-DNA和PreS1阳性率差异均有统计学意义（χ^2=11．73，28．55，P〈0．05）；LHBs含量与HBV—DNA拷贝数和表面抗原浓度呈正相关性（r=0．905，0．801，P〈0．05）；阳性组间LHBs含量与ALT指数无相关性。结论乙肝患者血清中LHBs的表达与HBV-DNA拷贝数、乙肝表面抗原浓度呈正相关，较PreS1-Ag更能反映乙肝患者病毒复制状况，尤其对HBeAg阴性患者抗病毒治疗及预后具有重要的指导意义，但不适用于判断肝细胞的受损程度。Objective To explore the clinical significance of hepatitis B virus large surface protein（LHBs） and its correlation with virus replication and liver impairment. Methods Randomly selected serum samples of 192 cases of hepatitis B patients from Wuhan General Hospital in March to June 2011, LHBs and HBV PreS1-Ag were measured by enzyme-linked immunosorhent assay （ELISA）,hepatitis B viral markers（HBV-M） and HBV-DNA were quantitatively detected hy chemoluminescence and real-time polymerase chain reaction respectively,automated biochemistry analyzer was used to detect the level of alanine amino-transferase（ALT）, and these serum biomarkers of HBV infection were comprehensively analyzed. Results The positive rates of LHBs and HBV-DNA had no significant difference（χ^22 =0. 32, P〉0. 05）,but significantly higher than PreS1-Ag detection rate （χ^2=23. 44, P〈0. 05） ,was found in the patients with positive HBeAg. The positive rate of LHBs was higher than that of HBV-DNA and PreS1 in HBeAg negative patients （χ^2 = 11.73, 28. 55, P〈0. 05）. Serum LHBs levels were correlated with the serum HBV-DNA copies and HBsAg content（ r=0. 905 and r=0. 801 respectively, P〈0.05） and not with level of ALT. Conclusion The results demonstrated that quantitative measurement of serum LHBs could reflect the replication of HBV, especially for the HBeAg negative patients,and the level of ALT is not suit for evaluation of the extent of liver cell damage.

关 键 词：乙肝表面抗原大蛋白 乙肝前S1抗原 乙肝表面抗原 HBV—DNA 谷氨酸氨基转移酶 

分 类 号：R512.62[医药卫生—内科学] R392.11[医药卫生—临床医学]