血清乙型肝炎病毒大蛋白对乙型肝炎病毒感染者的检测意义  

The clinical utility of serum HBV-LP testing in patients with HBV infection

作　　者：高嫣妮[1] 李筱莉[1] 崔兆磊 陈岩松[1] 叶倩[1] 陈燕[1] GAO Yanni,LI Xiaoli,CUI Zhaolei,CHEN Yansong,YE Qian,CHEN Yan △(Department of Clinical Laboratory/Fujian Cancer Hospital,Affiliated Tumor Hospitalof Fujian Medical University/Fujian Provincial Key Laboratory of Tumor Biotherapy,Fuzhou,Fujian 350014,China)

机构地区：[1]福建省肿瘤医院检验科/福建医科大学附属肿瘤医院检验科/福建省肿瘤生物治疗重点实验室,福州350014

出　　处：《检验医学与临床》2018年第17期2547-2550,共4页Laboratory Medicine and Clinic

摘　　要：目的检测乙型肝炎病毒(HBV)感染者的乙型肝炎病毒大蛋白(HBV-LP)表达,分析其与HBV-DNA、HBV-M、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、甲胎蛋白(AFP)的相关性。方法选取283例HBV感染者(HBsAg阳性)作为观察组,同时选取60例健康体检者作为对照组。采用酶联免疫吸附试验(ELISA)方法检测HBV-LP水平、HBV两对半指标;使用荧光定量(PCR)法检测HBV-DNA;应用化学发光法检测AFP、ALT、AST。结果 283例观察组患者HBV-LP阳性200例(70.7%),HBV-DNA阳性160例(56.5%),HBV-LP和HBV-DNA总检出率为79.9%(226/283);HBV-DNA中等程度复制组和高复制组HBV-LP表达量比较,差异有统计学意义(P<0.05)。37例大三阳患者HBV-LP、HBV-DNA检出率分别为100.0%和91.9%,差异无统计学意义(P=0.240);219例小三阳患者HBV-LP、HBV-DNA检出率分别为66.2%和50.2%,差异有统计学意义(P=0.001)。HBeAg、HBeAb阴性患者HBV-LP与HBV-DNA检出率差异均有统计学意义(均P<0.05)。相关性分析显示,HBV-LP表达与HBV-DNA含量呈正相关(r=0.464,P=0.000)。HBV-LP阳性患者ALT、AST、AFP水平高于HBV-LP阴性患者(均P<0.05)。结论 HBVLP可很好地反映HBV感染患者病毒复制、肝细胞损伤、疗效监测。Objective To detect the expression levels of HBV-LP in patients with chronic hepatitis and investigate associations between HBV-LP and HBV-DNA,HBV-M,ALT,AST and AFP. Methods A total of 283 HBsAg positive patients with chronic hepatitis were included,and another 60 healthy individuals were utilized as paired controls.Levels of serum HBV-LP were detected by ELISA,and that for HBV-DNA were determined be real time PCR.Status of AFP,ALT,and AST levels as well as HBV casset was measured by chemiluminescence analysis.Associations between HBV-LP and HBV-DNA,HBV-M,ALT,AST and AFP were assessed by Spearman′s correlation test. Results HBV-LP and HBV-DNA positive cases respectively account for 70.7% （200/283） and 56.5% （160/200） of all included patients,corresponding to a total positive detection rate of 79.9% （226/283）.Significant differences were observed between HBV-Moderate copy group and high copy group （ P 〈0.05）.The positive detection rate of HBV-LP and HBV-DNA were 100.0% and 91.9 % respectively,among all 37 HBsAg,HBeAg and HBcAb positive cases,with no statistical differences between groups （ P =0.240）.Another 219 HBsAg,HBeAb and HBcAb positive cases revealed a positive detection rate of 66.2% in HBV-LP test,which is higher than that in HBV-DNA test （50.2%, P =0.001）.The positive detection rate of HBV-LP and HBV-DNA were substantially different among HBeAg and HBeAb negative cases （ P 〈0.05）.Spearman′s correlation test showed that HBV-LP levels were positively correlated to HBV-DNA copies （ r =0.464, P =0.000）.The levels of ALT,AST and AFP in HBV-LP positive cases were higher than that in HBV-LP negative cases （ P 〈0.05）. Conclusion Serum HBV-LP testing is an important parameter in monitoring HBV replication and prognosis,and could be utilized as promising indicator in surveillance of the outcomes of antiviral treatment in Hepatitis B.

关 键 词：乙型肝炎病毒大蛋白 乙型肝炎病毒感染 DNA 

分 类 号：R446[医药卫生—诊断学]