乙肝病毒外膜大蛋白检测在临床诊断与治疗中的意义

何丽苇; 陈会欣

doi:10.13201/j.issn.1004-2806-b.2018.08.005

乙肝病毒外膜大蛋白检测在临床诊断与治疗中的意义

何丽苇,
陈会欣^,

- 武汉市第一医院输血科(武汉, 430022)
基金项目:
武汉市卫生计生委医疗卫生科研资助项目(No:WX15B16)

详细信息

通讯作者: 陈会欣,E-mail:huixinchen2007@163.com

收稿日期: 2017-11-24

Clinical significance of hepatitis B virus large protein detection in clinical diagnosis and treatment

HE Liwei,
CHEN Huixin^,

- Department of Blood Transfusion, Wuhan NO. 1. Hospital, Wuhan, 430022, China

More Information

Corresponding author: CHEN Huixin, E-mail: huixinchen2007@163.com

Received Date: 24 November 2017

摘要

摘要: 目的:对乙肝病毒血清学标志物HBV-M(包括HBsAg、HBsAb、HBeAg、HBeAb、HBcAb),乙肝病毒外膜大蛋白(HBV-Lp),乙肝病毒前S1抗原(HBV-Pres1)和乙肝病毒脱氧核糖核酸(HBV-DNA)联合检测结果进行比较,观察乙肝病毒外膜大蛋白(HBV-Lp)检测在临床诊断治疗乙肝中的应用价值,寻求比现有常规检测更敏感、更准确的实验室乙肝检测方法。方法:将感染科461例标本分成5组进行比较分析:78例乙肝表面抗原(吸收度A值<1)阴性血清标本为A对照组;9例HBsAg弱阳性(吸收度A值为1~2)血清标本为B组;201例HBsAg阳性(吸收度A值>2)且HBV-DNA含量<5×10²IU/ml的血清标本为C组;133例HBsAg阳性(吸收度A值>2)且HBV-DNA含量5×10²~5×10⁵IU/ml的血清标本为D组;40例HBsAg阳性(吸收度A值>2)且HBV-DNA含量>5×10⁵IU/ml的血清标本为E组。用酶联免疫吸附法检测HBV-M,HBV-Lp和HBV-Pres1,PCR-荧光探针法定量检测HBV-DNA。结果:A组和B组未见Pre-S1和HBV-LP结果异常。C、D、E组中HBeAg的阳性率依次为0.99%,6.02%,77.50%;Pre-S1的阳性率依次为29.35%,42.86%,90.00%;HBV-LP的阳性率依次为38.31%,55.64%,95.00%,HBV-LP、HBeAg和Pre-S1的阳性率可能性均随着HBV-DNA含量的增加而增大(P<0.05)。C、D、E组中HBeAg、Pre-S1和HBV-LP的检出率分别为10.96%,40.64%,50.53%,HBV-LP的检出率明显高于HBeAg和Pre-S1的检出率(P<0.05)。通过对相同HBV-DNA含量组的HBV-LP、HBeAg和Pre-S1阳性率进行统计学t检验比较,可以看出HBV-LP的检出率明显高于HBeAg和Pre-S1的检出率(P<0.05)。C、D、E组中HBV-LP的平均吸收度A值依次为2.53,5.35,13.93。HBV-DNA含量的增加伴随着有HBV-LP浓度的增加(P<0.05)。结论:HBV-LP检测比HBeAg和Pre-S1检测敏感性强,被检出的可能性更大,漏检的可能性更小。HBV-LP检测与HBV-DNA检测呈正相关性,HBV-LP在HBsAg阳性而HBV-DNA检测阴性时有理想的检出率,可能会对乙型肝炎诊断治疗进行补充作用。
- 乙肝大蛋白 /
- 乙肝前S1抗原 /
- 乙肝脱氧核糖核酸 /
- 乙肝血清标志物
Abstract: Objective:By comparing the result of serological markers for hepatitis B virus HBV-M(including HBsAg,HBsAb,HBeAg,HBeAb,HBcAb),hepatitis B virus large outer membrane protein(HBV-Lp),former S1 antigen hepatitis B virus(HBV Pres1)and hepatitis B virus DNA(HBV DNA),observe the value of hepatitis B virus large outer membrane protein(HBV-Lp)in the clinical diagnosis and treatment of viral hepatitis B,to seek a more sensitive and accurate method of laboratory testing than the existing conventional detection.Method:The 461 specimens from the Infectious Disease Department of the hospital were divided into five groups for comparison and analysis:78 cases of serum specimens with HBsAg negative(absorbance A value is<1)for control group A;9 cases of serum specimens with HBsAg weak positive(absorbance A value is 1-2)were in group B;201 cases of serum specimens with HBsAg positive(absorbance A value is>2)and HBV-DNA content<5×10²IU/ml were in group C;133 cases of serum specimens with HBsAg positive(absorbance A value is>2)and HBV-DNA content 5×10²-5×10⁵IU/ml were in group D;40 serum samples with HBsAg positive(absorbance A value is>2)and HBV-DNA content>5×10⁵IU/ml were group E.HBV-M,HBV-Lp and HBV-Pres1 were detected by enzyme-linked immunosorbent assay,and HBV-DNA was quantitatively detected by PCR-fluorescence probe method.Result:No abnormalities of Pre-S1 and HBV-LP were found in groups A and B.The positive rates of HBeAg in the C,D and E groups were 0.99%,6.02%,and 77.50%,respectively;the positive rates of Pre-S1 were 29.35%,42.86%,and 90.00%,respectively;the positive rate of HBV-LP was 38.31%,55.64%,95.00%,The positive possibility of HBV-LP,HBeAg and Pre-S1 increased with the increase of HBV-DNA content(P<0.05).The detection rates of HBeAg,Pre-S1,and HBV-LP in the C,D,and E groups were 10.96%,40.64%,and 50.53%,respectively.The detection rate of HBV-LP was significantly higher than that of HBeAg and Pre-S1(P<0.05).By comparing the HBV-LP,HBeAg,and Pre-S1 positive rates of the same HBV-DNA content group by statistical t test,it can be seen that the detection rate of HBV-LP is significantly higher than the detection rate of HBeAg and Pre-S1(P<0.05).The average absorbance A values of HBV-LP in the C,D,and E groups were 2.53,5.35,and 13.93,respectively.The increase in HBV-DNA content was accompanied by an increase in HBV-LP concentrations(P<0.05).Conclusion:HBV-LP has a more sensitive and higher detection rate than HBeAg and Pre-s1.The detection of HBV-LP was positively correlated with the detection of HBV-DNA,HBV-LP had an idealdetection rate when HBsAg was positive and HBV-DNA was negative,which may complement the diagnosis and treatment of hepatitis B.
- HBV-LP /
- HBV Pres1 /
- HBV-DNA /
- HBV-M

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