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目的了解乙型肝炎病毒(HBV)前S1(Pre-S1)抗原与HBV血清标志物、HBV-DNA之间的关系,并评价其临床意义。方法采用酶联免疫吸附试验(ELISA)检测276例乙型肝炎患者的pre-S1蛋白和乙肝五项指标,运用荧光定量PCR技术检测其HBV-DNA,分析三者之间的关系。结果不同乙肝五项指标模式的Pre-S1抗原与HBV-DNA的检测结果相比较,差异无统计学意义(P>0.05);在165例HBV-DNA阳性标本中Pre-S1抗原和HBeAg的检出率分别为84.2%和65.4%,HBV-DNA与Pre-S1抗原检出符合率达84.6%,差异无统计学意义(P>0.05),HBV-DNA与HBeAg检出符合率为70.2%,差异有统计学意义(P<0.05)。结论前S1抗原(pre-S1)能够敏感的反映乙型肝炎病毒的复制情况,尤其可以反映HBeAg阴性患者是否有病毒复制。与HBV-DNAPCR法相比,方法直接、操作简单、价格低廉,可作为HBV感染及复制的标志,为乙型肝炎的诊断、治疗和预后判断提供依据,具有重要的临床意义。
Objective To understand the relationship between Pre-S1 antigen and HBV serum markers and HBV-DNA in hepatitis B virus (HBV) and evaluate its clinical significance. Methods The enzyme-linked immunosorbent assay (ELISA) was used to detect the pre-S1 protein and hepatitis B in 276 hepatitis B patients. HBV-DNA was detected by fluorescence quantitative PCR and the relationship among them was analyzed. Results There was no significant difference between the Pre-S1 antigen and the HBV-DNA in the five indicators of hepatitis B (P> 0.05). Pre-S1 antigen and HBeAg in 165 HBV-DNA positive specimens The positive rates of HBV-DNA and Pre-S1 were 84.6% and 84.2%, respectively (P> 0.05). The coincidence rate of HBV-DNA and HBeAg was 70.2% The difference was statistically significant (P <0.05). Conclusion The pre-S1 antigen can reflect the replication of hepatitis B virus in a sensitive way and especially reflect the virus replication in HBeAg-negative patients. Compared with HBV-DNAPCR method, the method is direct, simple and inexpensive, and can be used as a marker of HBV infection and replication, providing a basis for diagnosis, treatment and prognosis of hepatitis B, and has important clinical significance.