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目的:通过检测乙型肝炎患者血清中乙肝病毒外膜大蛋白(LHBs)水平,探讨LHBs与HBV-DNA的关系以及LHBs对HBeAg阴性乙肝患者的临床应用价值。方法:分别采用ELISA法、时间分辨免疫荧光分析法和实时荧光定量PCR法检测678例HBV感染者的LHBs、HbeAg和HBV DNA。结果:(1)678例HBV感染者血清中,LHBs和HBV-DNA的阳性率分别为74.78%和70.65%,两者差异无统计学意义(P>0.05),两者的检出一致率为71.68%;(2)187例HBeAg阳性血清中,LHBs和HBVDNA的阳性检出率分别是94.12%和92.51%;491例HBeAg阴性血清中LHBs和HBVDNA阳性检出分别是67.41%和53.78%,两者差异均无统计学意义(P>0.05);(3)LHBs含量与HBV-DNA拷贝数之间具有较好相关性,r=0.978,LHBs含量随HBV-DNA的拷贝数增加而增加,不同HBV-DNA拷贝数组别间LHBs水平差异有统计学意义;(4)479例HBV-DNA阳性标本中,LHBs的阳性率明显高于HBeAg的阳性率,分别是82.88%和36.12%,差异有统计学意义(P<0.01)。结论:乙肝病毒外膜大蛋白可以作为判断HBV复制的血清学指标,尤其是对HBeAg阴性的慢性乙型肝炎患者具有更重要的临床实用价值。
Objective: To investigate the relationship between LHBs and HBV-DNA and the clinical value of LHBs in patients with HBeAg-negative hepatitis B by detecting the levels of hepatitis B virus outer membrane large protein (LHBs) in patients with hepatitis B virus. Methods: LHBs, HbeAg and HBV DNA were detected in 678 cases of HBV infection by ELISA, time-resolved immunofluorescence assay and real-time fluorescence quantitative PCR respectively. Results: (1) The positive rates of LHBs and HBV-DNA in serum of 678 HBV infected patients were 74.78% and 70.65%, respectively. There was no significant difference between the two (P> 0.05) 71.68%; (2) The positive detection rates of LHBs and HBVDNA were 94.12% and 92.51% respectively in 187 cases of HBeAg positive sera. The positive detection rates of LHBs and HBVDNA in 491 HBeAg negative sera were 67.41% and 53.78% (P> 0.05). (3) There was a good correlation between LHBs content and HBV-DNA copy number, r = 0.978. The content of LHBs increased with the increase of HBV-DNA copy number (4) The positive rate of LHBs in 479 cases of HBV-DNA positive specimens was significantly higher than that of HBeAg (82.88% and 36.12% respectively), the differences were statistically significant Significance (P <0.01). Conclusion: The large outer membrane protein of hepatitis B virus can be used as a serological marker to judge HBV replication, especially for patients with HBeAg-negative chronic hepatitis B.