乙肝五项血清标志物、PreS1抗原和HBV-DNA联合检测在老年乙型肝炎患者诊疗中的应用价值研究  

Application value of combined detection of five hepatitis B serum markers,PreS1 antigen and HBV-DNA in diagnosis and treatment of elderly patients with hepatitis B

作　　者：冯变莹 穆迪[1] 黄平[1] 周浩[1] 罗菲 姚祖德 满秋红 Feng Bianying;Mu Di;Huang Ping;Zhou Hao;Luo Fei;Yao Zude;Man Qiuhong(Department of Clinical Laboratory,Shanghai Fourth People's HospitalAffiliated to TongjiUniversity,Shanghai,200081,P.R.China)

机构地区：[1]同济大学附属上海市第四人民医院检验科,上海200081

出　　处：《老年医学与保健》2020年第4期613-617,共5页Geriatrics & Health Care

基　　金：上海市虹口区卫生健康委员会面上项目(虹卫1902-13)。

摘　　要：目的分析老年乙型肝炎患者进行乙肝五项血清标志物、HBV-DNA和Pre S1抗原定量联合检测的情况,探索不同年龄段老年乙型肝炎患者的这些指标检测结果之间的相关性及诊疗价值。方法回顾性分析2017年8月2019年12月于上海市第四人民医院门诊及住院治疗的210例老年乙型肝炎患者的临床资料,依据年龄大小分为3个年龄段,再根据乙肝五项结果分为5组(将乙肝五项血清标志物HBsAg、HBsAb、HBeAg、HBeAb和HBcAb分别采用①、②、③、④和⑤表示),分析各组Pre-S1抗原定量结果和阳性率及HBV-DNA阳性表达率在不同年龄段患者中的情况和这些指标之间的相关性。结果(1)各组PreS1抗原定量检测结果均与年龄呈负相关(R^2=0.95、0.93、0.97、0.95、0.98);各组相同年龄段患者Pre-S1抗原定量比较,①+③+⑤阳性组Pre-S1抗原定量结果要高于①+④+⑤阳性组、①+④阳性组和①+⑤阳性组(P<0.05);①+③+⑤阳性组与①+③阳性组Pre-S1抗原定量结果差异无统计学意义(P>0.05)。(2)各组同年龄段患者HBV-DNA的阳性率和Pre-S1的阳性率有统计学差异(P<0.05);各组不同年龄段患者HBV-DNA和Pre-S1的阳性率比较,①+④阳性组HBV-DNA和Pre-S1的阳性率无显著性差异(P>0.05),①+③+⑤阳性组、①+④+⑤阳性组、①+③阳性组、①+⑤阳性组的HBV-DNA阳性率和Pre-S1的阳性率有统计学差异(P<0.05)。(3)各组同年龄段HBeAg阳性组的Pre-S1阳性率显著高于HBeAg阴性组(P<0.05);(4)各组同年龄段患者HBV-DNA阳性组的Pre-S1阳性率显著高于HBV-DNA阴性组(P<0.05)。结论乙肝五项血清标志物、Pre-S1抗原定量和HBV-DNA三者联合检测,能够更早、更精准的反映不同年龄老年乙型肝炎患者病毒的感染水平、复制程度、传染性,对临床诊疗评估具有一定的指导意义。Objective To analyze the combined detection of five serum markers of hepatitis B,HBV-DNA and PreS1 antigen in elderly patients with hepatitis B ant to explore the correlation between the detection results of these indicators in elderly hepatitis B patients of different ages and the value of diagnosis and treatment.Methods The clinical data of 210 elderly patients with hepatitis B from August 2017 to December 2019 in Shanghai Fourth People's Hospital were retrospectively analyzed.According to the age,these patients were divided into three age groups,and then they were divided into 5 groups according to the results of hepatitis B detection(HBsAg,HBsAb,HBeAg,HBeAb and HBcAb were expressed by①,②,③,④and⑤,respectively).The quantitative results and positive rate of Pre-S1 antigen in each group and the positive expression rate of HBVDNA in different age groups and the correlation between these indicators were analyzed.Results(1)The quantitative detection results of PreS1 antigen in each group were negatively correlated with age(R^2=0.95,0.93,0.97,0.95,0.98).Quantitative comparison of Pre-S1 antigen in patients of the same age in each group:the quantitative results of Pre-S1 antigen in①+③+⑤positive group were higher than those of①+④+⑤positive group,①+④positive group and①+⑤positive group(P<0.05);there was no significant difference in the quantitative results of Pre-S1 antigen between①+③+⑤positive group and①+③positive group(P>0.05).(2)The positive rate of HBV-DNA and Pre-S1 of patients in the same age group were statistically different(P<0.05);comparison of the positive rates of HBV-DNA and Pre-S1 in patients of different ages in each group:the positive rates of HBV-DNA and Pre-S1 in①+④positive groups were not significantly different(P>0.05),the HBV-DNA positive rate and Pre-S1 positive rate of①+③+⑤positive group,①+④+⑤positive group,①+③positive group,①+⑤positive group were statistically different(P<0.05).(3)In the same age groups,the positive rate of Pre-S1 in

关 键 词：老年 乙型肝炎 年龄段 乙肝五项 乙型肝炎病毒核酸 乙型肝炎病毒前S1抗原 

分 类 号：R512.62[医药卫生—内科学] R446[医药卫生—临床医学]