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目的探讨乙型肝炎病毒大蛋白(LHBs)的检测及对判定病毒复制情况以及抗病毒治疗的临床意义。方法选取保定市传染病医院573例乙肝患者,应用酶联免疫吸附试验(ELISA)检测血清中的LHBs、HBVM,应用实时定量荧光PCR方法检测HBV DNA水平;同时,通过随访研究,观察78例阿德福韦抗病毒治疗后患者LHBs与HBV DNA水平的关系。结果HBeAg阴性及阳性组的乙肝患者中,HBV DNA的阳性检出率与LHBs的阳性率差异均不具统计学意义;②抗病毒治疗患者HBVDNA和LHBs均呈下降趋势,但是LHBs的消减晚于HBVDNA;③抗病毒治疗过程中,乙型肝炎病毒人蛋白持续阳性组的HBV DNA阴转率低于LHBs阴转组(抗病毒治疗18个月LHBs持续阳性的患者比12个月时LHBs阳性的患者,继续接受治疗后DNA阴转的概率降低56%。结论LHBs能够反映HBeAg阴性乙肝患者病毒复制的水平,是HBV M检测的有益的补充;抗病毒治疗过程中LHBs和HBV DNA下降的趋势一致,抗病毒治疗过程中LHBs持续阳性者,HBV DNA出现阴转的概率降低,联合检测LHBs和HBV DNA对抗病毒治疗监测具有重要临床意义。
Objective To investigate the detection of hepatitis B virus large protein (LHBs) and its clinical significance in judging the virus replication and antiviral therapy. Methods 573 patients with hepatitis B from the Infectious Disease Hospital of Baoding City were enrolled. Serum LHBs and HBVM were detected by enzyme-linked immunosorbent assay (ELISA). HBV DNA levels were detected by real-time quantitative PCR. Meanwhile, 78 patients Relationship between LHBs and HBV DNA level after anti - virus treatment with. Results The positive rate of HBV DNA and the positive rate of LHBs in HBeAg-negative and HBeAg-positive patients were not statistically different. ②The HBVDNA and LHBs in the patients with HBeAg negative and positive groups showed a decreasing trend, but the LHBs disappeared later than those in HBVDNA ; ③ During the course of antiviral therapy, the HBV DNA negative conversion rate of patients with sustained positive of hepatitis B virus human protein was lower than that of patients with LHBs negative conversion (patients with positive LHBs at 18 months after antiviral therapy were more positive than LHBs at 12 months , And the probability of DNA negative conversion decreased by 56% after the treatment was continued.Conclusion LHBs can reflect the level of virus replication in HBeAg-negative hepatitis B patients and is a useful complement to HBV M detection. The tendency of LHBs and HBV DNA declining in the course of antiviral therapy is the same, LHBs persistently positive during antiviral therapy and the probability of negative conversion of HBV DNA is low. Combined detection of LHBs and HBV DNA is of great clinical significance in the monitoring of antiviral therapy.