乙型肝炎病毒外膜大蛋白与乙肝病毒核酸检测在抗病毒治疗中的价值分析  

Clinical value of the joint detection of hepatitis B virus large protein and HBV-DNA in antiviral therapy

作　　者：袁军[1] 张艳[1] 詹颉[1] 

机构地区：[1]陕西省人民医院检验科,陕西西安710068

出　　处：《蚌埠医学院学报》2015年第12期1703-1705,共3页Journal of Bengbu Medical College

摘　　要：目的:探讨乙型肝炎病毒外膜大蛋白(HBV-LP)与乙型肝炎病毒核酸(HBV-DNA)检测在抗病毒治疗中的临床价值。方法:选取300例乙型肝炎患者,均给予核苷(酸)类似物抗病毒治疗,分别在治疗前和治疗后6、12个月采集血清标本进行HBV-LP、HBV-DNA检测,并对检测结果进行统计分析。结果:不同HBV-DNA拷贝组的HBV-LP吸光度差异有统计学意义(P<0.01)。HBV-LP含量与HBV-DNA拷贝数具有正相关关系;HBV-LP、HBe Ag、HBV-DNA阳性率均随着治疗时间的延长而降低,与治疗前相比差异均有统计学意义(P<0.01),但在治疗6个月及12个月HBV-LP的阳性率均高于HBV-DNA的阳性率(P<0.01)。随着抗病毒治疗时间的延长,HBV-LP的灵敏度降低,特异度升高,阳性预测值降低,治疗后12个月时,HBVLP的灵敏度最低(93.28%),特异性最高(53.01%)。结论:HBV-DNA阴转并不意味着肝内乙型肝炎病毒复制的消失,联合检测HBV-LP以检测病毒复制,对抗病毒治疗监测具有重要的临床价值。Objective： To explore the clinical value of the joint detection of hepatitis B virus large protein（ HBV-LP） and hepatitis B virus DNA（ HBV-DNA） in antiviral therapy. Methods： Three hundred patients with hepatitis B were treated with antiviral therapy. The serum levels of HBV-LP and HBV-DNA in all patients were detected before treatment and after 6 and 12 months of treatment,the result of which was analyzed. Results： The difference of HBV-LP in different HBV-DNA copies patients was statistical significance（ P 0. 01）. The HBV-LP content was positive correlation with HBV-DNA copies. The positive rates of HBV-LP,HBe Ag and HBV DNA decreased with the time extension of treatment,and the differences of whose between before and after treatment were statistical significance（ P 0. 01）. The positive rates of HBV-LP were higher than that of HBV-DNA after 6 and 12 months of treatment（ P 0. 01）. With the time extension of antiviral treatment,the sensitivity,specificity and positive predictive value of HBV-LP decreased,increased and decreased,respectively. The sensitivity（ 93. 28%） and specificity（ 53. 01%） of HBV-LP were the lowest and highest after 12 months of treatment. Conclusions： The negative HBV-DNA does not mean the disappearance of intrahepatic HBV replication.The joint detection of HBV-LP and HBV-DNA can detect the virus replication,which has important clinical value in monitoring antiviral treatment.

关 键 词：乙型肝炎 乙型肝炎病毒外膜大蛋白 乙肝病毒核酸 抗病毒 

分 类 号：R512.62[医药卫生—内科学]