CAJ | 학술논문

目的分析HBV DNA与PreS1以及ALT在乙型肝炎患者血清中的检测情况,分析其相互关系,评价其联合检测的价值.方法采用荧光定量PCR法检测HBV DNA,同时用ELISA方法检测PreS1蛋白、动力学方法检测ALT,并分析其相互关系.结果 HBeAg阳性组中HBV DNA、PreS1检出率分别为97.1%、94.3%(x~2=0.17,P>0.05).HBsAg+、抗HBe+和抗HBc+组中HBV DNA、PreS1的检出率分别为47.4%、73.7%,表明部分HBeAg阴性、抗HBe+患者仍有病毒复制.HBsAg+、抗HBc+组中HBV DNA、PreS1的检出率分别为65.8%、89.5%,而ALT在这3组中的异常率差异无统计学意义(x~2分别为2.18、1.93、0.03,均P>0.05),说明血清ALT虽对肝细胞损害极为敏感但缺乏特异性.ALT异常组中HBV DNA和PreS1检出率分别为78.6%、86.3%,两者相关性较高(x~2=2.64,P>0.05),ALT正常组中HBV DNA和PreS1检出率差异有统计学意义(x~2=9.68,P<0.01).PreS1与HBV DNA检出率不一致,可能是PreS1和HBV DNA检测所表达的意义并不完全一致.结论 HBV DNA、PreS1以及ALT在乙型肝炎患者血清中所表达的意义各有侧重,在实际工作中应联合检测,互相补充,这样对乙型肝炎患者的诊断与治疗会有更高的临床价值.
목적 분석HBV DNA여PreS1이급ALT재을형간염환자혈청중적검측정황,분석기상호관계,평개기연합검측적개치.방법 채용형광정량PCR법검측HBV DNA,동시용ELISA방법검측PreS1단백、동역학방법검측ALT,병분석기상호관계.결과 HBeAg양성조중HBV DNA、PreS1검출솔분별위97.1%、94.3%(x~2=0.17,P>0.05).HBsAg+、항HBe+화항HBc+조중HBV DNA、PreS1적검출솔분별위47.4%、73.7%,표명부분HBeAg음성、항HBe+환자잉유병독복제.HBsAg+、항HBc+조중HBV DNA、PreS1적검출솔분별위65.8%、89.5%,이ALT재저3조중적이상솔차이무통계학의의(x~2분별위2.18、1.93、0.03,균P>0.05),설명혈청ALT수대간세포손해겁위민감단결핍특이성.ALT이상조중HBV DNA화PreS1검출솔분별위78.6%、86.3%,량자상관성교고(x~2=2.64,P>0.05),ALT정상조중HBV DNA화PreS1검출솔차이유통계학의의(x~2=9.68,P<0.01).PreS1여HBV DNA검출솔불일치,가능시PreS1화HBV DNA검측소표체적의의병불완전일치.결론 HBV DNA、PreS1이급ALT재을형간염환자혈청중소표체적의의각유측중,재실제공작중응연합검측,호상보충,저양대을형간염환자적진단여치료회유경고적림상개치.
Objective To analyze the association of HBV DNA,PreS1 with ALT,and evaluate the clinical value of combined detection.Methods Fluorescence quantitative PCR was applied to detecring HBV DNA,enzyme linked immunosorbent assay(ELISA)was adopted to measure PreS1 protein,and kinetic method was employed to measure serum level of alanine aminotransferase(ALT).The teat results were compared and analyzed.Results The detection rates of HBV DNA and PreS1 were respectively 97.1%and 94.3%in HBeAg positive group,with a highly positive correlation(X~2=0.17,P>0.05),while in the HBsAg+,anti-HBe+and anti-HBc+group,the detection rates were respectively 47.4%and 73.7%,indicating that the viral replication still occurred in some patients with anti-HBe positive,HBeAg negative.The detection rates of HBV DNA and PreS1 were respectively 65.8%and 89.5%in HBsAg+,anti-HBc+group.However,the detection rates of ALT in these three groups were no significant difference(X~2 was 2.18,1.93 and 0.03 respectively,P>0.05).It was illustrated that the ALT was sensitive to hepatocyte damage but not specific.The detection rates of HBV DNA and Presl were respectively 78.6%and 86.3%in ALT abnormal group,with high positive correlation(X~2=2.64,P>0.05).While in the group of normal ALT group,HBV DNA and Pres1 detection rates were quite different,showing their different clinical significance(X~2=9.68,P<0.01).Conclusion The clinical value of HBV DNA,Pres1 and ALT in HBV patients is different,so combined detection shoule be performed so as to improve diagnosis and treatment of hepatitis B.