抗HBCIGM前S1抗原与HBVDNA在乙肝诊断中相关性探讨.docVIP

抗HBCIGM前S1抗原与HBVDNA在乙肝诊断中相关性探讨 　　【摘要】目的 探讨乙型肝炎病毒抗HBcIgM、前S1抗原(HBV PreS1-Ag)与HBV-DNA的相关性。方法 从临床检测HBV-M的标本中筛出HBV阳性病例203例,采用ELISA法检测抗HBcIgM、HBV PreS1-Ag和荧光定量PCR法检测标本HBV-DNA,并与5例HBV-M全阴性血清进行比较,同时采用酶法检测所有血清标本的ALT和AST。结果 抗HBcIgM、HBV Pre-S1Ag 和HBV-DNA在HBeAg(+)组中检出率分别为73.6%、90.2%和100%,在HBsAg(+)+HBeAb(+)+HBcAb(+)组中检出率为38.9%、42.5%和48.1%。在HBsAg(+)+HBcAb(+)、HBsAg(+)、HBeAb+HBcAb三组中,抗HBcIgM、HBV-DNA和HBV Pre-S1Ag仍有一定检出率。抗HBc-IgM(+)组中,ALT和AST异常率分别占74.3%和65.8%.HBV Pre-S1Ag(+)组中,ALT和AST异常率分别占54.3%和46.7%。结论 抗HBcIgM是乙型病毒性肝炎早期诊断和监测慢性肝炎急性发作的重要指标,HBV-DNA阳性检出率通常被当作HBV感染及复制的金标准,HBV低廉,指示急性乙型肝炎向慢性转变。评估Pre-S1Ag与HBV-DNA的符合率较高,是对HBV-M和HBV-DNA测定的重要补充和加强,在没有条件开展HBV-DNA定量的广大基层医院, 进行HBV-M检测时,抗HBcIgM和HBV Pre-S1Ag联合检测,互补共存,可以更好地服务于临床。 　　【关键词】HBV-M抗HBcIgMHBV-DNA前S1抗原 　　【中图分类号】R115 【文献标识码】A 【文章编号】1004-7484(2010)03-00-02 　　 　　【ABSTRACT】ObjectiveTo study the relationship of the Anti-HBc-IgM. HBV Pre-sAg. HBV-DNA. HBV-M and hepatic enzyme in patient infected with HBV.Methods The serum Anti-HBc-IgM. Pre-s1 antige and HBV-DNA were tested by ELISA and real-time fluorescent quantitative PCR(RT-PCR) in 203 patients infected with HBV screening HBV-M by ELISA method .At the mean time . and 5 HBV-M negative samples were tested.ALT and AST were tested by rate method in all samples. Results the positive rates ofthe Anti-HBc-IgM.the Pre-S1Ag.and HBV-DNA were 73.6%.90.2% and 100% separately.The positive detection rates for the Anti-HBc-IgM. pre-S1Ag and HBV-DNA in the HbsAg(+)+HbeAb(+)HbcAb(+) model were 38.9%. 42.5% and 48.1% separately.There still had a little positive rate of the Anti-HBc-IgM. Pre-S1Ag and HBVDNA in the HbsAg(+)+HbcAb(+) model .HbsAg(+) model and HbeAb+HbcAb model. .The abnormal rate of ALT and AST in the Anti-HBc-IgM’s postive model were higher than that in Anti-HBc-IgM’s negative model (ALT 74.3% and 31.7%,AST65.8% and 30.1%).The abnormal rate of ALT and AST in the pre-S1Ag’s postive model were higher than that in pre-s1Ag’s negative model (ALT 54.3% and 0,AST46.7% and 0).Conclusion .Anti-HB