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目的 了解前S1蛋白 (PreS1)与乙型肝炎病毒 (HBV)复制的关系 ,及诊断乙型肝炎的价值。方法 采用酶联免疫吸附试验 (ELISA)方法对 32 4 3例携带乙型肝炎不同病毒标志物的慢性乙型肝炎患者血清进行PreS1测定并与HBVDNA做对比分析。检测 5 8例急性发病的经肝活检病理诊断为慢性乙型肝炎患者的血清 ,分析其不同病程的PreS1,HBeAg和HBVDNA三者间的关系。根据肝活检病理的肝组织炎症情况分为G1～G4级 ,对 4 9例PreS1和HBVDNA阳性病例进行分析比较。检测 39例不同病程急性乙型肝炎患者血清 ,分析PreS1和HBVDNA与丙氨酸氨基转移酶 (ALT)间的关系。结果 乙型肝炎病毒表面抗原 (HBsAg)、乙型肝炎病毒e抗原(HBeAg)、乙型肝炎病毒核心抗体 (HBcAb)阳性组与PreS1和HBVDNA符合率分别为 86 %和 88% ,P >0 .0 5 ,不同病程慢性乙型肝炎患者血清PreS1、HBeAg和HBVDNA检出率高度符合。HBsAg抗HBe抗HBc阳性组与PreS1和HBVDNA符合率分别为 36 %和 35 % ,说明部分HBeAg阴性患者仍有病毒复制。不同病程急性乙型肝炎患者血清PreS1和HBVDNA与ALT之间的关系 ,PreS1与ALT相比符合率高 ,P >0 .0 5。HBVDNA与ALT相比符合率较低 ,P <0 .0 1。病理肝组织G1～G4炎症分级与PreS1和HBVDNA高度吻合。结论 PreS1能够敏感地反映乙型肝炎病
Objective To understand the relationship between PreS1 and hepatitis B virus (HBV) replication and the value of diagnosing hepatitis B patients. Methods Serum samples from 32 patients with chronic hepatitis B carrying hepatitis B virus markers were assayed by enzyme-linked immunosorbent assay (ELISA) for serum PreS1 and compared with HBVDNA. Fifty-eight cases of acute hepatitis B were diagnosed by pathological biopsy, and the relationship among PreS1, HBeAg and HBVDNA was analyzed. According to liver biopsy pathological liver inflammation were divided into G1 ~ G4 grade, 49 cases of PreS1 and HBVDNA positive cases were analyzed and compared. The serum levels of PreS1, HBVDNA and alanine aminotransferase (ALT) were determined in 39 patients with acute hepatitis B with different course of disease. Results The coincidence rates of HBsAg, HBeAg and HBcAb positive with PreS1 and HBVDNA were 86% and 88% respectively (P> 0). 0 5, different duration of chronic hepatitis B serum PreS1, HBeAg and HBVDNA detection rate in line with. The coincidence rates of HBsAg anti-HBe anti-HBc positive group with PreS1 and HBVDNA were 36% and 35% respectively, which indicated that some HBeAg-negative patients still had virus replication. PreS1 and HBVDNA in patients with different stages of acute hepatitis B had a higher coincidence rate with ALT (P> 0.05). The coincidence rate of HBVDNA with ALT was lower, P <0.01. Pathological liver tissue G1 ~ G4 inflammation grade and PreS1 and HBVDNA highly consistent. Conclusion PreS1 can reflect hepatitis B disease sensitively