乙型肝炎患者血清中前S_1蛋白、HBcAg及HBVDNA相关性临床研究  

Clincal research on the correlation of pre-S_1, HBcAg and HBV DNA in the serum of hep-atitis B patient

作　　者：车达平[1] 徐龙[1] 张志成[1] 

机构地区：[1]南昌市第九医院,南昌330002

出　　处：《江西医药》2003年第6期403-406,共4页Jiangxi Medical Journal

摘　　要：目的探讨乙型肝炎患者血清前S1(Pre-S1)蛋白、HBcAg、HBVDNA及HBV其他标志物的关系及临床意义,为评判HBV复制和病情发展提供新的思路与证据。方法对136例乙型肝炎患者血清中HBVDNA应用微板核酸杂交法;HBcAg采用ELISA间接法,两种抗体包被,反应孔内裂解Dane颗粒的酶标技术直接检测;Pre-S1及HBV其他标志物同时进行ELISA检测。结果血清中Pre-S1、HBcAg、HBVDNA检出率在HBsAg、HBeAg、抗-HBc组合中最高,分别为33.3%、74.6%、85.7%,与HBV-M其它组合比较P<0.01;HBeAg和HBcAg阳性组的HBVDNA、Pre-S1检出率最高(91.7%、39.6%),其次为HBeAb和HBcAg阳性组;HBVDNA阳性组的Pre-S1、HBcAg检出率(27.5%、62.6%)明显高于阴性组(2.2%、8.9%),P<0.001;Pre-S1阳性血清中HBcAg与HBVDNA检出率为96.4%、89.3%,与阴性组比较P<0.001及P<0.05;Pre-S1、HBcAg与HBVDNA检出率在各临床类型患者中,除慢性肝炎HBVDNA检出率高,且统计学意义(P<0.001)外,其它无特异性。结论血清Pre-S1、HBcAg、HBVDNA和HBeAg均是反映乙肝病毒复制的敏感指标,具有较好的相关性。抗HBe的出现并不表示病毒复制停止,应参考其他病毒复制指标情况。乙型肝炎各临床类型HBV复制指标检出率仅HBVDNA具有特异性。Objective To approach the relationship of Pre-S 1 ,HBcAg,HBV DNA with other HBV markers in the serum of hepatitis B patient and their clinical significance,and to put forward new train of thought and evidence available for the as-sessment of HBV replication and progress of ill-ness.Method The nucleic acid hybridization on millipore plate is applied for HBV DNA in the serum of136hepatitis B patients;indirect detec-tion of HBcAg by ELISA,two kinds of antibodies coated,direct detection of lytic Dane particles in reaction pore by ELISA;simultaneous detection of Pre-S 1 and other HBV markers by ELISA.Result The detection rate of Pre-S 1 ,HBcAg,HBV DNA in serum is highest in the combined HBsAg,HBeAg and anti-HBc,respectively at33.3%,74.6%and85.7%,and as compared with other combined HBV-M,P<0.01;the detection rate of HBV DNA and Pre-S 1 is highest(91.7%and39.6%)in the HBeAg and HBcAg positive group,and then in the HBeAb and HBcAg positive group;the detection rate of Pre-S 1 and HBcAg in the HBV DNA posi-tive group(27.5%and62.6%)is obviously higher than the negative group(2.2%and8.9%),P<0.001;the detection rate of HBcAg and HBV DNA is96.4%and89.3%in the Pre -S 1 positive serum,and as compared with the negative group,P<0.001and P<0.05;The detection rate of Pre-S 1 ,HBcAg and HBV DNA for every clinical hepatitis patient shows no specificity,except a high detection rate of HBV DNA for chronic hepatitis which has sta-tistical significance(P<0.001).Conclusion The Pre-S 1 ,HBcAg,HBV DNA and HBeAg in serum are all the sensitivity indexes of Hepatitis B virus replication and with better correlativeness.The presence of anti -HBe does not indicate that the virus replication stops,and for that,other indexes of virus replication must be considered.The detec-tion rate of every clinical HBV replication index for hepatitis B shows specificity in HBV DNA.

关 键 词：乙型肝炎 血清 前S1蛋白 HBCAG HBVDNA 相关性 临床研究 

分 类 号：R512.62[医药卫生—内科学]