Pre S1、HBV-DNA及乙肝五项指标对乙型肝炎肝脏纤维化诊断的临床价值  

The Clinical Values of Pre S1,HBV-DNA and Five Makers of Hepatitis B in the Diagnosis of Hepatitis B with Hepatic Fibrosis

作　　者：罗艳[1] LUO Yan(Department of Laboratory,West District Hospital,Chengdu 610031,China)

机构地区：[1]成都市西区医院检验科,四川成都610031

出　　处：《标记免疫分析与临床》2020年第1期53-57,62,共6页Labeled Immunoassays and Clinical Medicine

基　　金：四川省普及应用项目(编号:17PJ180)。

摘　　要：目的分析血清前S1抗原(Pre S1)、乙肝病毒DNA(HBV-DNA)及乙肝五项指标对乙型肝炎肝脏纤维化诊断的临床价值。方法选取2017年1月至2019年2月我院收治的乙型肝炎患者276例,其中慢性乙型肝炎228例(轻度、中度、重度分别89、80、59例)、肝硬化48例,分析其血清Pre S1、HBV-DNA载量、乙肝五项指标、肝纤维化指标[血清Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(CⅣ型)、层连蛋白(LN)、透明质酸(HA)]水平,对比不同乙型肝炎患者的HBV-DNA载量、乙肝五项者指标的差异,采用Spearman法分析相关性。结果肝硬化患者血清Pre S1阳性率、HBV-DNA载量均高于慢性乙型肝炎(P<0.05);肝硬化组血清PCⅢ、CⅣ、LN、HA水平较慢性乙型肝炎者高,且在慢性乙型肝炎中随病情加重,患者PCⅢ、CⅣ、LN、HA水平上升(P<0.05);随HBV DNA载量增加,乙型肝炎患者血清Pre S1阳性率及血清PCⅢ、CⅣ、LN、HA水平增加(P<0.05);大三阳组Pre S1阳性率、HBV-DNA载量均高于其他各组(P<0.05),小三阳组Pre S1阳性率、HBV-DNA载量也高于除大三阳组外的其他各组(P<0.05);Spearman相关分析显示,乙型肝炎患者血清Pre S1阳性率、HBV-DNA载量与乙肝大三阳、小三阳及血清PCⅢ、LN均存呈正相关,Pre S1阳性率与HBV-DNA载量也呈正相关(P<0.05)。结论Pre S1、HBV-DNA及乙肝五项指标均可较好判断乙型肝炎患者肝脏纤维化程度,值得在基层医院推广。Objective To analyze the clinical values of serum Pre S1 antigen(PreS1),hepatitis B virus DNA(HBV-DNA)and five makers of hepatitis B in the diagnosis of hepatitis B with hepatic fibrosis.Methods 276 patients with hepatitis B who were admitted to the hospital from January,2017 to February,2019 were selected for the study,including 228 patients with chronic hepatitis B(89 mild cases,80 moderate cases and 59 severe cases)and 48 patients with liver cirrhosis.Levels of serum Pre S1,HBV-DNA load,five markers of hepatitis B and liver fibrosis indexes[serum type III procollagen(PCIII),type IV collagen(CIV type),laminin(LN),hyaluronic acid(HA)]were measured.The above indicators were compared between patients with different hepatitis B,HBV-DNA loads and five markers of hepatitis B,and their correlations were analyzed by Spearman method.Results The positive rate of serum Pre S1 and HBV-DNA load in patients with liver cirrhosis were higher than those in the control group(P<0.05).The levels of serum PCIII,CIV,LN and HA in the liver cirrhosis group were higher than those in the chronic hepatitis B group,and the levels increased with the severity of chronic hepatitis B(P<0.05).With the increase of HBV DNA load,the positive rate of serum Pre S1 and levels of serum PCIII,CIV,LN and HA increased in patients with hepatitis B(P<0.05).The positive rate of serum Pre S1 and HBV-DNA load in the HBsAg,HBeAg and HBcAb positive group were higher than those in other groups(P<0.05).The positive rate of serum Pre S1 and HBV-DNA load in the HBsAg,HBeAb and HBcAb less positive group were also higher than those in other groups(P<0.05).Spearman correlation analysis showed that the positive rate of serum PreS1 and HBV-DNA load in patients with hepatitis B were positively correlated with HBsAg,HBeAg and HBcAb positive hepatitis B,HBsAg,HBeAg and HBcAb less positive hepatitis B,serum PCIII and LN.The positive rate of PreS1 was positively correlated with HBV-DNA load(P<0.05).Conclusion The Pre S1,HBV-DNA and five markers of hepatitis B can all be use

关 键 词：PRE S1 HBV-DNA 乙肝五项 乙型肝炎 肝脏纤维化 

分 类 号：R512.62[医药卫生—内科学]