术前筛查HBeAg阴性HBV感染者检测乙肝大蛋白的意义

摘要

Objective To detect serum hepatitis B virus large surface protein (HBV-LP) in preoperative screening in subjects with normal liver function and patients with HBeAg-negative hepatitis B infection,and to evaluate the significance of serum HBV-LP in the patients with hepatitis B.Methods HBV-LP,hepatitis B S1 (HBVpreS1) were measured by ELISA,and HBV DNA levels were detected by fluorescence quantitative PCR in 180 HBeAg-negative HBV patients in preoperative screening.Results In the 180 patients,the positive rates of PreS1-Ag,HBV-LP and HBV DNA were 21.1％,34.4％ and 32.7％,respectively.x2 test showed that the positive rates of three groups had significant difference (x2=9.145 7,P=0.010 3).Scheffe test showed that the positive rate of PreS1-Ag detection was significantly lower than that of HBV-LP and HBV DNA (P＜0.05),while no significant difference was found in the positive rates of HBV-LP and HBV DNA detection (P＞0.05).HBV-LP and HBV DNA showed no significant differences in detection results (x2=0.173 9,P=0.676 7).At the same time,correlation analysis showed a good correlation between HBV-LP and HBV DNA detection (x 2=95.655,P=0.0000,r=0.721 7).The scatter plot of 49 cases ofHBV DNA copy number per ml (copies/ml) commonly used numerical and quantitative HBV-LP OD showed a positive correlation (r=0.6192).Conclusion HBV-LP,superior to HBVpreS1,is a good indicator in response to viral replication.There was a good correlation between HBV-LP and HBV-DNA detection,which can be used as a substitute and supplement of hepatitis B infection in hospital.%目的 了解肝功能正常、HBeAg阴性HBV感染的术前筛查患者乙肝大蛋白(HBV-LP)阳性情况,评判血清HBV-LP检测在这类乙型肝炎患者中的意义.方法 使用ELISA法检测180例HBeAg阴性HBV感染的术前筛查患者HBV-LP、乙肝前S1 (HBVpreS1),同时采用实时定量PCR法做HBV DNA水平检测.结果 180份HBeAg阴性HBV感染血清PreS1-Ag、HBV-LP和HBV DNA检测阳性率分别为21.1％、34.4％和32.7％,x2检验显示三组检测阳性率差异有统计学意义(x2=9.145 7,P=0.010 3),用Scheffe法做率的两两比较显示:PreS 1-Ag检测阳性率明显低于HBV-LP和HBV DNA (P＜0.05),而HBV-LP和HBV DNA检测阳性率差异无统计学意义(P＞0.05).HBV-LP和HBV DNA配对检测显示结果差异无统计学意义(x2=0.173 9,P=0.6767),同时相关性分析示良好相关性(2=95.655,P=0.000 0,r=0.721 7).49例HBV DNAcopies/ml常用对数值与HBV-LP定量OD值的散点图显示正相关(r=0.6192).结论 对术前筛查HBeAg阴性乙型肝炎携带者,HBV-LP在反应病毒复制方面是一个优于HBVpreS1检测的良好指标,与HBV DNA检测有良好的相关性,在不能开展HBV DNA检测的基层单位可作为评价乙型肝炎传染性的一种替代与补充.