摘要
目的 对比分析乙型肝炎病毒外膜大蛋白（HBV-LP）、乙型肝炎病毒DNA（HBV-DNA）和前S1抗原（Pre S1-Ag）评价慢性乙型肝炎（CHB）患者血清中乙型肝炎病毒复制状况的有效性.方法 收集2013年6月至2015年3月在合肥某医院就诊的482例CHB患者的血清标本,采用ELISA法检测HBV-LP、乙型肝炎病毒标志物（HBV-M）和Pre S1-Ag;实时荧光定量PCR检测HBV-DNA.比较HBV-DNA、HBV-LP、Pre S1-Ag阳性率的差异,采用Spearman秩相关分析HBV-DNA拷贝数的对数值和HBV-LP的吸光度值相关性.结果 482例CHB患者HBV-DNA、HBV-LP和Pre S1-Ag阳性率分别为67.22%（324/482）、73.86%（356/482）和37.34%（180/482）（P〈0.01）;339例HBeAg阴性CHB患者的3项指标阳性率分别为54.57%（185/339）、64.90%（220/339）和27.73%（94/339）（P〈0.01）.在HBeAg阴性患者中,185例为HBV-DNA阳性,HBV-LP阳性率为90.81%（168/185）,高于Pre S1-Ag[39.46%（73/185）]（P〈0.01）;154例患者HBV-DNA阴性,其HBV-LP阳性率为33.77%（52/154）,也高于Pre S1-Ag的13.64%（21/154）（P〈0.01）.HBsAg、HBeAg、HBcAb阳性患者HBV-DNA、HBV-LP、Pre S1-Ag阳性率分别为97.04%（131/135）、94.81%（128/135）和60.00%（81/135）（P〈0.01）;HBsAg、HBeAb、HBcAb阳性患者3项指标阳性率分别为53.74%（122/227）、63.88%（145/227）和27.31%（62/227）（P〈0.01）;HBsAg、HBcAb阳性患者3项指标的阳性率分别为55.79%（53/95）、67.37%（64/95）和28.42%（27/95）（P〈0.01）.HBV-LP的吸光度值随着HBV-DNA拷贝数的对数值增加而呈上升趋势（Spearman秩相关系数=0.908,P〈0.01）.结论 HBV-LP与HBV-DNA载量对数值之间的相关性良好,可作为HBV-DNA和HBV-M检测的有效补充,较Pre S1-Ag更能反映CHB患者的病毒复制状态.
Objective To investigate the comparative study of serum hepatitis B virus（HBV） large protein（HBV-LP）, HBV-DNA, and Pre S1 antigen （Pre S1-Ag） detection in the evaluation of serum HBV replication in patients with chronic hepatitis B. Methods A total of 482 patients infected with chronic hepatitis B virus （CHB） were enrolled and the serums were collected in a hospital of Hefei city in Anhui province from June 2013 to March 2015. The serum HBV-LP, HBV markers（HBV-M） and Pre S1-Ag were detected using ELISA, and HBV-DNA were quantified using quantitative real-time PCR. The positive detection rate difference of HBV-DNA, HBV-LP and Pre S1-Ag were compared, the correlation between the logarithm of HBV-DNA copies number and the absorbance value of HBV-LP was analyzed using Spearman rank correlation. Results The positive rates of HBV DNA, HBV-LP, and Pre S1-Ag were 67.22% （324/482）, 73.86% （356/482）, and 37.34% （180/482）, respectively （P〈0.01）. The positive rates of the three markers were 54.57% （185/339）, 64.90% （220/339）, and 27.73% （94/339）, respectively, in 339 HBeAg-negative CHB patients （P〈0.01）. In HBeAg negative patients, the positive rate of HBV-LP in 185 cases of HBV-DNA positive samples was 90.81% （168/185）, which was higher than that of Pre S1-Ag with rate of 39.46% （73/185） （P〈0.01）.The positive rate of HBV-LP was 33.77% （52/154） in 154 cases of patients with negative HBV-DNA whose positive rate was higher than Pre S1-Ag with positive rate of 13.64% （21/154） （P〈0.01）. The positive rates of HBV-DNA, HBV-LP and Pre S1-Ag in HBsAg, HBeAg and HBcAb positive groups were 97.04% （131/135）, 94.81% （128/135）, and 60.00% （81/135）, （P〈0.01）; The positive rates of three indexes of HBsAg, HBeAb, HBcAb positive group were 53.74% （122/227）, 63.88% （145/227）, and 27.31% （62/227） ; The positive rates of three indexes of HBsAg and HBcAb positive group were 55.79% （53/95）, 67.37% （64/95）, and 28.42% （27/95�
作者
夏芳
徐元宏
郑美娟
汪学龙
Xia Fang Xu Yuanhong Zheng Meijuan Wang Xuelong(Department of Parasitology, Anhui Medical University, Hefei 230032, Chin)
出处
《中华预防医学杂志》
CAS
CSCD
北大核心
2017年第6期501-505,共5页
Chinese Journal of Preventive Medicine
基金
国家自然科学基金（81302525）
