血清HBV-LP测定在乙型肝炎病毒活动性感染诊断中的意义  

Diagnostic Significance of Hepatitis B Virus Large Surface Protein for Chronic Active HBV Infection

作　　者：俞莹[1,2] 范倩燕 陈颖[1] 钱嬿[1] 凌雯[1] 卢大儒[2] 

机构地区：[1]同济大学附属杨浦医院检验科,上海200093 [2]复旦大学生命科学院,上海200093

出　　处：《药物生物技术》2015年第5期425-427,共3页Pharmaceutical Biotechnology

基　　金：上海市杨浦区卫生局青年科研项目(No.201305)

摘　　要：探讨血清乙型肝炎病毒大蛋白(Hepatitis B virus large surface protein,HBV-LP)检测在乙型肝炎病毒活动性感染诊断中的临床意义。选择慢性乙型肝炎病毒(HBV)感染者194例,其中HBV-DNA阳性患者144例,HBV-DNA阴性患者50例。采用化学发光法检测乙肝两对半及HBc Ab-Ig M,酶联免疫吸附试验(ELISA)检测HBV-LP,采用实时荧光定量PCR技术检测HBV-DNA。194例慢性HBV感染者中,活动性感染者92例(47.4%),非活动性感染者102例(52.6%)。HBe Ag阳性患者107例(55.2%),阴性患者87例(44.8%)。HBe Ag阳性患者中,活动性感染者64例,非活动性感染者43例。HBe Ag阴性患者中,活动性患者28例,非活动性患者59例。活动性感染者与非活动性感染者之间HBV-LP水平存在统计学差异,(105.8±76.4)vs(59.0±60.3),P<0.001。受试者工作特征(ROC)曲线分析表明HBV-LP对HBV活动性感染诊断价值较低,曲线下面积(AUC)为0.689。进一步分层分析表明,HBV-LP对HBe Ag阴性活动性感染无诊断价值(AUC=0.547),但对HBe Ag阳性活动性感染具有一定的诊断价值(AUC=0.707)。乙型肝炎病毒慢性活动性感染患者HBV-LP显著升高,测定血清中的HBV-LP对HBe Ag阳性慢性活动性乙肝具有一定诊断价值。To study diagnostic significance of Hepatitis B virus large surface protein in serum for chronic active HBV infection, serum samples were collected from 194 patients with hepatitis B. Among the 197 samples, 144 samples were HBV-DNA positive and 54 samples were HBV-DNA negative. Chemiluminescence assay （CLIA） was used to measure the levels of serum HBsAg, HBsAb, HBeAg, anti-HBe,anti-HBc,and HBcAb-IgM. ELISA was used to measure the level of serum HBV-LP. FQ-PCR was used to detect HBV-DNA. Results showed that among the 194 patients with chronic hepatitis B ,92 （47.4%） patients were active infection, and 102 （52.6%） patients were inactive infection. There were 107 （55.2%） HBeAg-positive and 87 （44, 8% ） HBeAg-negative patients. Among HBeAg-positive patients ,64 were active and 43 were inactive infection. Among HBeAg-negative patients ,28 were active and 59 were inactive infection patients, HBV-LP levels were significantly different between active and inactive infection, （105.8 ± 76.4） vs （ 59.0 ± 60. 3 ） ,P 〈 0. 001. Receiver operation characteristic （ ROC ） curve analysis showed that HBV-LP was not a good marker for diagnosis of active HBV infection. The area under curve（AUC） was 0. 689. Further stratified analysis showed that for HBeAg-negative patients,levels of HBV-LP had little diagnostic value of active HBV infection. For HBeAg-positive patients, however, levels of HBV-LP had certain diagnostic value of HBV active infection （ AUC = 0.707 ）. HBV-LP levels were significantly higher in chronic active HBV infected patients than those in inactive HBV infected patients. Measurement of serum HBV-LP may be helpful for diagnosis of active HBV infection in HBeAg-positive patients.

关 键 词：乙型肝炎病毒 乙型肝炎病毒大蛋白 乙型肝炎病毒-脱氧核糖核酸 慢性活动性肝炎 聚合酶链式反应 酶联免疫吸附试验 

分 类 号：R512.62[医药卫生—内科学]