论文部分内容阅读
目的探讨乙型肝炎e抗原阴性[HBeAg(-)]乙肝患者血清乙肝病毒大蛋白(HBV-LP)和乙肝前S1抗原(PreS1-Ag)联合检测的临床意义。方法采用酶联免疫吸附(ELISA)法测定300例慢性乙肝患者的血清HBV-LP和PreS1-Ag浓度;实时荧光定量PCR(qRT-PCR)法检测血清HBV-DNA表达量;比较不同HBV-M模式下HBV-LP、PreS1-Ag与HBV-DNA的阳性检出率;分析以HBV-DNA表达量作为HBV感染及复制的金标准时,血清HBV-LP和PreS1-Ag单独检测及联合检测对HBeAg阴性乙肝患者的阳性预测值和阴性预测值。结果 (1)115例HBeAg(+)血清中,HBV-LP和PreS1-Ag的阳性率均与HBV-DNA阳性率差异无统计学意义(Ps>0.05);120例HBeAg(-)HBeAb(+)血清中,HBV-LP阳性率(64.2%)明显高于HBV-DNA阳性率(P<0.05),而PreS1-Ag阳性率与HBVDNA阳性率差异无统计学意义(P>0.05);65例HBeAg(-)HBeAb(-)血清中,HBV-LP阳性率(72.3%)和PreS1-Ag阳性率(67.7%)均明显高于HBV-DNA阳性率(Ps<0.05);(2)以185例HBeAg(-)乙肝患者的HBV-DNA表达量为参考标准,HBV-LP、PreS1-Ag的阳性预测值分别为72.6%、71.6%,阴性预测值分别为93.4%、84.1%;HBV-LP和PreS1-Ag联合检测,HBV-LP/PreS1-Ag双阳性中的HBV-DNA阳性率(66.0%)显著高于HBV-LP/PreS1-Ag双阴性(P<0.05)。结论血清HBV-LP和PreS1-Ag水平与HBV-DNA表达量有关,二者联合检测可灵敏地反映HBeAg(-)乙肝患者HBV的复制状态,预测HBV-DNA水平。
Objective To investigate the clinical significance of combined detection of serum hepatitis B virus large protein (HBV-LP) and preS1-Ag in patients with hepatitis B e antigen negative [HBeAg (-)]. Methods Serum levels of HBV-LP and PreS1-Ag were measured by enzyme-linked immunosorbent assay (ELISA) in 300 patients with chronic hepatitis B. The levels of serum HBV-DNA were detected by real-time quantitative PCR (qRT- LP, PreS1-Ag and HBV-DNA were detected by ELISA. When HBV-DNA was used as the gold standard for HBV infection and replication, the serum levels of HBV-LP and PreS1-Ag were detected individually and the combined detection of HBeAg Negative hepatitis B patients with positive predictive value and negative predictive value. Results (1) The positive rates of HBV-LP and PreS1-Ag in 115 cases of HBeAg (+) serum were not significantly different from those of HBV-DNA (Ps> 0.05); 120 cases of HBeAg (-) HBeAb ), The positive rate of HBV-LP (64.2%) was significantly higher than that of HBV-DNA (P <0.05), but there was no significant difference between PreS1-Ag positive rate and HBVDNA positive rate The positive rate of HBV-LP (72.3%) and PreS1-Ag (67.7%) were significantly higher than that of HBV-DNA in HBeAg (-) HBeAb (- The positive predictive value of HBV-LP and PreS1-Ag were 72.6% and 71.6%, respectively, and the negative predictive values were 93.4% and 84.1%, respectively. HBV-LP The positive rate of HBV-DNA in HBV-LP / PreS1-Ag double positive (66.0%) was significantly higher than that in HBV-LP / PreS1-Ag (P <0.05) Conclusions Serum levels of HBV-LP and PreS1-Ag are correlated with the level of HBV-DNA. The combined detection of serum HBV-LP and PreS1-Ag can sensitively reflect the replication status of HBV in patients with HBeAg (-) hepatitis B and predict the level of HBV-DNA.