贵州医科大学学报

2018, v.43;No.219(12) 1436-1440

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Pre-S1Ag和Pre-S2Ag及HBV-LP在乙肝病毒筛查中的价值
Clinical Value of Pre-S1Ag,Pre-S2Ag and HBV-LP in Hepatitis B Virus Screening

刘军辉;汪靖园;王林川;肖尧;阮竞雄;闫芳;
LIU Junhui;WANG Jingyuan;WANG Linchuan;XIAO Yao;RUAN Jingxiong;YAN Fang;Department of Clinical Laboratory,The First Affiliated Hospital of Xi'an Jiaotong University;Department of Blood Transfusion,Xi'an NO.3 Hospital;

摘要(Abstract):

目的:探讨乙肝病毒(HBV)前S1抗原(Pre-S1 Ag)、前S2抗原(Pre-S2 Ag)及乙肝大蛋白(HBV-LP)在乙肝病毒(HBV)筛查中的价值。方法:258例乙肝患者分为乙肝表面抗原(HBs Ag)携带组(n=182)及HBV DNA阳性组(n=76),另选100例健康体检者作为对照组;采用双抗体夹心(ELISA)法检测受检者血清Pre-S1Ag、Pre-S2 Ag及HBV-LP水平,比较Pre-S1 Ag、Pre-S2 Ag及HBV-LP筛查HBV的灵敏度和特异度,分析Pre-S1Ag、Pre-S2 Ag及HBV-LP对HBs Ag携带组3种血清学模式患者的HBV检出能力;采用线性回归法分析Pre-S1Ag、Pre-S2 Ag、HBV-LP与HBV DNA的相关性,推算3个指标的ABV病毒检出限。结果:Pre-S1 Ag、Pre-S2 Ag及HBV-LP应用于HBV筛查的特异度为99%~100%,但Pre-S2 Ag和HBV-LP筛查HBV的灵敏度显著高于Pre-S1 Ag(P <0. 01); HBe Ag阴性人群中(HBs Ag-HBeAb-HBcAb阳性和HBs Ag-HBcAb阳性模式)的Pre-S2 Ag、HBV-LP检出率均显著高于Pre-S1 Ag (P <0. 01); Pre-S1 Ag、Pre-S2 Ag及HBV-LP与HBV DNA正相关(r=0. 82、0. 76、0. 70,P <0. 01),Pre-S2 Ag、HBV-LP对HBV的检出限接近106IU/L,Pre-S1 Ag对HBV的检出限≥108IU/L。结论:Pre-S2 Ag、HBV-LP相较于Pre-S1 Ag具有更高的灵敏度和更低的检出限,更适合作为HBV筛查的血清标志物。
Objective: To investigate the clinical values of the pre-S1 antigen( Pre-S1 Ag),pre-S2antigen( Pre-S2 Ag) and hepatitis B virus large protein( HBV-LP) in screening hepatitis B virus( HBV). Methods: According to HBV markers,258 patients were divided into two groups: one group( n = 182) with hepatitis B surface antigen( HBsAg) and another group( n = 76) is HBV DNA positive. 100 healthy subjects were used as control group. Serum Pre-S1 Ag,Pre-S2 Ag and HBV-LP levels were measured by its own specific ELISA kit. The sensitivity,specificity and detection limit of PreS1 Ag,Pre-S2 Ag and HBV-LP levels in screening HBV were compared between HBsAg-carrying group and HBV DNA-positive group. In addition,their correlations with viral load were also analyzed.The association of Pre-S1 Ag,Pre-S2 Ag and HBV-LP with HBV DNA was analyzed by linear regression. Results: In HBV screening,the specificity of Pre-S1 Ag,Pre-S2 Ag and HBV-LP was 99% ~100%,but the sensitivity of Pre-S2 Ag and HBV-LP in HBsAg-carrying group and HBV DNA-positive group is significantly higher than Pre-S1 Ag( P < 0. 01). The sensitivity of Pre-S2 Ag and HBV-LP was significantly higher than that of Pre-S1 Ag for HBsAg carriers( 86. 81% 、85. 71% vs 48. 9%) and HBV DNA positive cases( 86. 84%,89. 47% vs 35. 53%),P < 0. 0001. Pre-S1 Ag,Pre-S2 Ag and HBV-LP were positively correlated with HBV DNA( r = 0. 82,0. 76,0. 70,P < 0. 01). The detection limit of Pre-S2 Ag,HBV-LP for HBV is around 106 IU/L,whereas the detection limit of Pre-S1 Ag for HBV is ≥108 IU/L. Conclusions: Pre-S2 Ag and HBV-LP have higher sensitivity and lower detection limit than Pre-S1 Ag,and thus are more suitable as serum markers for HBV screening.

关键词(KeyWords): 肝炎病毒,乙型;前S1抗原;前S2抗原;乙肝大蛋白;酶联免疫吸附试验;灵敏度;特异度
hepatitis B virus;pre-S1 antigen;pre-S2 antigen;hepatitis B large protein;enzymelinked immunosorbent assay;sensitivity;specificity

Abstract:

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基金项目(Foundation): 国家自然科学基金资助项目(81500219);; 陕西省科学技术研究发展计划项目(2016SF-217)

作者(Author): 刘军辉;汪靖园;王林川;肖尧;阮竞雄;闫芳;
LIU Junhui;WANG Jingyuan;WANG Linchuan;XIAO Yao;RUAN Jingxiong;YAN Fang;Department of Clinical Laboratory,The First Affiliated Hospital of Xi'an Jiaotong University;Department of Blood Transfusion,Xi'an NO.3 Hospital;

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DOI: 10.19367/j.cnki.1000-2707.2018.12.014

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