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目的检测不同乙肝血清模式下前S1抗原(Pre S1)以及乙肝病毒脱氧核糖核酸(HBVDNA)的结果 ,并探讨三者的关系及临床意义。方法用酶联免疫吸附试验(ELISA)方法对500例乙肝患者血清进行乙肝血清标志物(HBV-M)和Pre S1检测,用荧光定量聚合酶链式反应(FQ-PCR)方法检测HBV-DNA。结果 Pre S1总阳性率为73.8%,HBV-DNA总阳性率为65.8%,差异无统计学意义(P>0.05);大三阳组中Pre S1阳性率为93.1%,HBV-DNA阳性率为100.0%,两者阳性率接近,差异无统计学意义(P>0.05);小三阳组中Pre S1阳性率为69.9%,HBV-DNA阳性率为45.8%,Pre S1阳性率明显高于HBVDNA,差异有统计学意义(P<0.01);乙型肝炎e抗原(HBe Ag)阳性组的Pre S1和HBV-DNA阳性率均明显高于HBe Ag阴性组,差异有统计学意义(P<0.01);在HBe Ag阳性组中,Pre S1和HBV-DNA阳性率相近,差异无统计学意义(P>0.05),在HBe Ag阴性组中,Pre S1阳性率高于HBV-DNA,差异有统计学意义(P<0.01)。结论 HBe Ag和Pre S1与HBV-DNA检测率高度相关,Pre S1与HBV-DNA既有一致性,又有互补性。对检测HBe Ag阴性的乙肝患者,Pre S1有独特的优势。乙肝血清标志物联合HBV-DNA以及Pre S1可作为乙型肝炎早期诊断和评价疗效的可靠指标,尤其在隐匿性乙型肝炎的诊断方面起到非常重要的作用。
Objective To detect the results of Pre S1 and HBVDNA in different serogroups of hepatitis B virus (HBV) and to explore their relationship and clinical significance. Methods Serum samples from 500 hepatitis B patients were tested for HBV-M and Pre S1 by enzyme-linked immunosorbent assay (ELISA), and HBV DNA was detected by FQ-PCR . Results The positive rate of Pre S1 was 73.8%, and the positive rate of HBV-DNA was 65.8% (P> 0.05). The positive rate of Pre S1 was 93.1% and the positive rate of HBV-DNA was 100.0% .The positive rate of Pre S1 was 69.9%, the positive rate of HBV-DNA was 45.8%, the positive rate of Pre S1 was significantly higher than that of HBVDNA (P> 0.05) (P <0.01). The positive rates of Pre S1 and HBV-DNA in HBeAg-positive group were significantly higher than those in HBe Ag-negative group (P <0.01), and the difference was statistically significant The positive rates of Pre S1 and HBV-DNA in HBeAg-positive group were similar (P> 0.05), but the positive rate of Pre S1 was higher than that of HBV-DNA in HBeAg-negative group Significance (P <0.01). Conclusion HBeAg and Pre S1 are highly correlated with the detection rate of HBV-DNA. Pre S1 and HBV-DNA are both consistent and complementary. Pre S1 has unique advantages for detecting HBeAg-negative hepatitis B patients. Hepatitis B serum markers combined with HBV-DNA and Pre S1 can be used as reliable indicators of early diagnosis and evaluation of hepatitis B, especially in the diagnosis of occult hepatitis B.