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探讨血清乙型肝炎病毒大蛋白(Hepatitis B virus large surface protein,HBV-LP)检测在乙型肝炎病毒活动性感染诊断中的临床意义。选择慢性乙型肝炎病毒(HBV)感染者194例,其中HBV-DNA阳性患者144例,HBV-DNA阴性患者50例。采用化学发光法检测乙肝两对半及HBc Ab-Ig M,酶联免疫吸附试验(ELISA)检测HBV-LP,采用实时荧光定量PCR技术检测HBV-DNA。194例慢性HBV感染者中,活动性感染者92例(47.4%),非活动性感染者102例(52.6%)。HBe Ag阳性患者107例(55.2%),阴性患者87例(44.8%)。HBe Ag阳性患者中,活动性感染者64例,非活动性感染者43例。HBe Ag阴性患者中,活动性患者28例,非活动性患者59例。活动性感染者与非活动性感染者之间HBV-LP水平存在统计学差异,(105.8±76.4)vs(59.0±60.3),P<0.001。受试者工作特征(ROC)曲线分析表明HBV-LP对HBV活动性感染诊断价值较低,曲线下面积(AUC)为0.689。进一步分层分析表明,HBV-LP对HBe Ag阴性活动性感染无诊断价值(AUC=0.547),但对HBe Ag阳性活动性感染具有一定的诊断价值(AUC=0.707)。乙型肝炎病毒慢性活动性感染患者HBV-LP显著升高,测定血清中的HBV-LP对HBe Ag阳性慢性活动性乙肝具有一定诊断价值。
To investigate the clinical significance of detection of Hepatitis B virus large surface protein (HBV-LP) in the diagnosis of Hepatitis B virus active infection. 194 patients with chronic hepatitis B virus (HBV) infection were selected, including 144 HBV-DNA positive patients and 50 HBV-DNA negative patients. The chemiluminescence method was used to detect HBc Ab-Ig M in two pairs and a half of hepatitis B, and HBV-LP was detected by enzyme-linked immunosorbent assay (ELISA). HBV-DNA was detected by real-time fluorescence quantitative PCR. Of the 194 patients with chronic HBV infection, 92 (47.4%) were active and 102 (52.6%) were inactive. 107 patients (55.2%) were HBeAg-positive patients and 87 patients (44.8%) were negative patients. Of the HBeAg-positive patients, 64 were active and 43 were inactive. Of the HBeAg-negative patients, 28 were active and 59 were inactive. The level of HBV-LP was significantly different between active and inactive patients (105.8 ± 76.4 vs 59.0 ± 60.3, P <0.001). The receiver operating characteristic (ROC) curve analysis showed that HBV-LP had a lower diagnostic value of HBV active infection, with an area under the curve (AUC) of 0.689. Further stratification analysis showed that HBV-LP had no diagnostic value for HBeAg-negative active infection (AUC = 0.547), but it had certain diagnostic value (AUC = 0.707) for HBeAg-positive active infection. HBV-LP in patients with chronic active hepatitis B virus was significantly increased, and the determination of serum HBV-LP in HBe Ag positive chronic active hepatitis B has a certain diagnostic value.