目的 探讨血清病毒外膜大蛋白(LHBs)与乙型肝炎病毒(HBV)感染和复制的相关性.方法 检测282例乙型肝炎患者和30名健康对照者血清HBV DNA载量、LHBs和乙型肝炎e抗原(HBeAg).以HBV DNA 载量为标准,对LHBs和HBeAg进行对比分析.结果 HBV DNA载量＜103拷贝/mL的107例乙型肝炎患者中LHBs阳性9例(8.41％),HBeAg阳性8例(7.48％)；LHBs、HBeAg与HBV DNA载量相同等级的线性相关系数分别为0.9721和0.8370(P ＜0.01、P＜0.05)；LHBs与HBeAg诊断HBV感染的敏感性分别为92.57％、62.35％,特异性分别为82.52％、77.17％,阳性预测值分别为77.43％、64.08％,阴性预测值分别为59.18％、51.22％,准确率分别为97.05％、89.16％.结论 LHBs能较好地反映HBV复制情况,对乙型肝炎患者进行LHBs、HBV DNA及HBeAg联合检测将有助于疾病的诊断、疗效观察及预后判断.%Objective To investigate the correlation of serum hepatitis B virus (HBV)large envelope protein (LHBs)with HBV infection and replication. Methods Serum HBV DNA load, LHBs and hepatitis B e antigen (HBeAg)of 282 patients with hepatitis B and 30 healthy controls were detected. LHBs was compared with HBeAg basing on HBV DNA load. Results Among 107 patients whose serum HBV DNA loads were < 103 copies/mL, 9(8.41% )patients were LHBs positive, and 8(7.48%)patients were HBeAg positive. The linear correlation coefficients of LHBs and HBeAg with the scale of HBV DNA load were 0. 972 1 and 0.837 0 respectively (P <0. 01, P <0. 05). To diagnose HBV infection, the sensitivities, specificities, positive predictive values, negative predictive values and accuracies of LHBs were 92.57% , 82.52% , 77.43% , 59.18% and 97.05% , respectively, and the values of HBeAg were 62.35% , 77. 17% , 64.08% , 51. 22% and 89. 16% , respectively. Conclusions LHBs is a good index to reflect the situation of HBV replication. The combined determination of LHBs, HBV DNA and HBeAg of hepatitis B patients contributes to the clinical diagnosis, therapeutic effect monitoring and prognosis evaluation.
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