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目的分析探讨e抗原阴性的慢性乙型肝炎病毒(HBV)患者体内病毒复制情况及其临床意义。方法乙肝五项检测采用酶联免疫吸附试验(ELISA),挑选出e抗原阴性的780例HbsAg阳性标本分为两组:A组,HbsAg HbeAb HbcAb阳性组(1、4、5阳性即小三阳模式组);B组,HbsAg HbcAb阳性组(1.5阳性组)。两组分别进行前s1抗原(ELISA法)和HBV-DNA含量检测[利用荧光定量聚合酶链反应(FQ-PCR)]法进行,以HBV-DNA拷贝数大于103copy/ml为阳性)。结果 (1)在小三阳模式组中,pre-SlAg总阳性率为39.57%,HBV-DNA总阳性率为43.40%,二者差异无统计学意义(P>0.05);(2)在1、5阳性模式组,pre-SlAg总阳性率为27.42%,HBV-DNA总阳性率为31.29%,两者差异无统计学意义;(3)两个模式组的pre-SlAg阳性率相比,差异有统计学意义(P<0.05),而HBV-DNA阳性率相比无统计学意义(P>0.05)。结论 (1)e抗原阴性时,小三阳模式组与1.5阳性组相比,pre-S1Ag的阳性率差异有统计学意义,HBV-DNA的阳性率差异无统计学意义;同一模式组下的pre-S1Ag与HBV-DNA阳性率比较接近,pre-S1Ag也可以反映HBV-DNA复制情况;(2)e抗原阴性时,并不一定体内无病毒复制,必须联合检测pre-S1Ag等指标,才能在乙肝病毒复制方面发挥重要作用。
Objective To investigate the clinical significance of virus replication in chronic hepatitis B virus (HBV) patients with negative e antigen. Methods Eighty-eight HbsAg positive specimens negative for e antigen were divided into two groups by enzyme-linked immunosorbent assay (ELISA). A group, HbsAg HbeAb HbcAb positive group (1,4,5 positive) Group B), HbsAg HbcAb positive group (1.5 positive group). Pre-s1 antigen (ELISA) and HBV-DNA content were measured in both groups (using FQ-PCR method), with a positive HBV-DNA copy number greater than 103copy / ml. Results (1) The positive rate of pre-S1Ag was 39.57% and the positive rate of HBV-DNA was 43.40% in the mini-Sanyang model group. There was no significant difference between the two groups (P> 0.05) 5 positive model group, the positive rate of pre-S1Ag was 27.42%, and the positive rate of HBV-DNA was 31.29%. There was no significant difference between the two groups (P <0.05), while the positive rate of HBV-DNA was not statistically significant (P> 0.05). Conclusions (1) The positive rate of pre-S1Ag was significantly different from that of negative group when positive for e antigen, but there was no significant difference between positive rate of HBV-DNA and negative group -S1Ag and HBV-DNA positive rate is relatively close, pre-S1Ag can also reflect the HBV-DNA replication; (2) e antigen negative, it is not necessarily virus-free replication in vivo, we must jointly detect pre-S1Ag and other indicators in order to Hepatitis B virus replication plays an important role.