18F-SFB-Annexin B1探测细胞凋亡实验研究

目的 在体外及体内评价自动化合成模块合成的18F-N-琥珀酰亚胺-4-氟苯甲酸酯(SFB)-膜联蛋白(Annexin)B1探测细胞凋亡.方法 使用anti-Fas抗体诱导Jurkat细胞发生凋亡,用流式细胞仪检测细胞凋亡存在.通过暂时性阻断家兔肾动脉(45 min)使单侧肾经缺血再灌注发生细胞凋亡,24 h后静脉注射18F-SFB-Annexin B1,分别于注射后10,30,60,90,120和240 min行PET/CT显像.采用原位末端标记法(TUNEL)和HE染色法证实肾存在细胞凋亡.结果 用antiFas抗体诱导后细胞调亡率实验组为25.98%(120 min),对照组仅为1.81%;实验组细胞对18F-SFBAnnexin B1的摄取高于对照组,在注射18F-SFB-Annexin B1后240 min PET/CT图像上,处理侧肾的放射性摄取高于正常对照肾.TUNEL和HE染色法证实处理侧肾存在大量细胞凋亡.结论 18F-SFB-Annexin B1保留了同磷脂酰丝氨酸(PS)结合的生物活性,在体外及体内探测细胞凋亡方面具有应用潜力.     

放射性核素细胞凋亡显像

放射性核素细胞凋亡显像具有直观、无创伤和实时在体观察细胞凋亡等特点,对于脑、心肌细胞缺血再灌注损伤的观察,器官移植排斥反应的监测,肿瘤放疗和化疗效果的评估等方面的应用前景良好,但仍有许多问题有待于进一步探讨.     

幼龄兔缺氧缺血性脑损伤的细胞凋亡显像研究

目的探讨99^Tc^m-联肼尼克酰胺．膜联蛋白Ⅴ（HYNIC-Annexin Ⅴ）在幼龄兔缺氧缺血性脑损伤（HIBD）细胞凋亡显像中的价值。方法制作幼龄兔假手术组、HIBD4h组、HIBD40h组模型，对各组动物行注药后60min平面脑显像和脑组织石蜡切片观察，对HIBD 40h组还进行注药后5，30，120min显像；用ROI技术计算各组动物脑患侧与健侧放射性计数比值（T／NT）；假手术组和HIBD4h组还进行MRI、弥散加权成像（DWI）。结果假手术组、HIBD4h组和HIBD40h组注药后60minT／NT分别为0．94±0．14，1．32±0．11，1．81±0．07（F=82．385，P〈0．01）；HIBD40h组不同时间（5，30，60，120min）显像获得的T／NT分别为1．72±0．04，1．77±0．06，1．81±0．07，1．71±0．03（F=3．994，P〉0．01）。切片观察假手术组脑组织未见凋亡细胞，HIBD4h组与HIBD40h组患侧脑见凋亡细胞，后者较明显；HIBD4h组MRI、DWI和表观弥散系数（ADC）图均未见异常。结论99^Tc^m-HYNIC-AnnexinⅤ显像可以早期发现神经细胞凋亡，在新生儿HIBD细胞凋亡的无创性诊断、抑制凋亡疗效评价和预后估计方面有重要的应用前景。     

99Tcm-HYNIC-Annexin V动脉粥样硬化显像的实验研究

目的 探讨99Tcm-联肼尼克酰胺(HYNIC)-膜联蛋白V(Annexin V)显像检测兔动脉粥样硬化(AS)病变的价值.方法 5只雄性日本大耳白兔通过免疫损伤血管和12周高脂饮食制备成AS模型(实验组),自兔耳缘静脉按体质量注射99Tcm-HYNIC-Annexin V 37 MBq/kg,分别行活体和离体血管的99Tcm-HYNIC-Annexin V显像.5只未经特殊处理的同种白兔行活体显像作为对照.对实验组兔的主动脉分段后,测定各片段质量和放射性计数,并进行病理学和免疫组织化学检查.采用SPSS 13.0软件对数据进行统计学处理.结果 显像剂注射后2h,实验组兔主动脉可见放射性摄取达峰值,而对照组未见明显的放射性摄取,前者靶/非靶(T/NT)比值(2.70±0.26)明显高于后者(1.30±0.13,t=1.99,P＜0.05).实验组兔的主动脉血管斑块片段放射性摄取(每克组织百分注射剂量率,%ID/g)为(0.075±0.016)%ID/g,明显高于非斑块血管片段[(0.035±0.013)%ID/g,前者是后者的(4.55±0.99)倍,t=4.77,P＜0.001];两者的凋亡细胞指数(AI)分别为(40.53±14.94)%和(11.90±7.09)%,差异具有统计学意义(t=2.54,P＜0.01).所有血管片段的放射性摄取(%ID/g值)与AI呈正相关(r=0.98,P＜0.001).结论 99Tcm-HYNIC-Annexin V可以无创性地检测AS斑块的凋亡.     

99Tcm-联肼尼克酰胺-膜联蛋白B1的制备及其探测细胞凋亡的生物学评价

目的 制备99Tcm-联肼尼克酰胺(HYNIC)-膜联蛋白(Annexin)B1并对其探测细胞凋亡的潜力进行生物学评价.方法 应用99Tcm间接标记蛋白质的方法,以HYNIC作为双功能螯合剂制备99Tcm-HYNIC-Annexin B1.采用与活化人血小板结合实验检测99Tcm-HYNIC-Annexin B1的体外生物活性.采用地塞米松诱导小鼠胸腺凋亡的动物模型和anti-Fas单克隆抗体诱导小鼠肝凋亡的动物模型(均设相应对照组),检测99Tcm-HYNIC-Annexin B1探测体内细胞凋亡的潜力,并用原位末端标记法(TUNEL)染色证实细胞凋亡.采用配对t检验进行统计学处理.结果 间接标记法制备的99Tcm-HYNIC-Annexin B1具有很高的放化纯(＞96%)和较好的体外稳定性.与活化人血小板的结合实验表明,99Tcm-HYNIC-Annexin B1具有与磷脂酰丝氨酸(PS)残基结合的生物活性.地塞米松诱导18 h后,小鼠胸腺对99Tcm-HYNIC-Annexin B1的摄取为对照组的3.50倍(t=5.234,P＜0.01).anti-Fas诱导后2 h时,小鼠肝对99Tcm-HYNIC-Annexin B1的摄取为对照组的2.02倍(t=6.178,P＜0.01).结论 采用99Tcm间接标记法制备的99Tcm-HYNIC-Annexin B1具有很高的放化纯及较好的体外稳定性.99Tcm-HYNIC-Annexin B1具有与PS结合的体外生物活性和探测体内细胞凋亡的潜力,是一种新的细胞凋亡显像剂.     

FDG模块自动化合成2-18F-乙酸盐及其临床前研究

目的研究国产商用^18F—FDG模块自动化合成2-^18F-乙酸盐的可行性及其肿瘤显像。方法在商用FDG模块上未经修改参数，采用柱色层水解和纯化合成2-^18F-乙酸盐，并进行了放化纯、稳定性检测，生物学分布实验及荷乳腺癌和肺腺癌小鼠显像。结果采用商用FDG模块自动化合成2-^18F-乙酸盐，无需高效液相色谱（HPLC）法纯化，时间短，产率高，平均合成效率达59．3％，放化纯〉99％，合成时间为23min。2-^18F-乙酸盐的稳定性高，毒性较低，正常鼠生物学分布示血液清除慢，PET显像示乳腺癌和肺腺癌特异性摄取示踪剂。结论2^18F-乙酸盐是一种有潜在应用前景的肿瘤显像剂。     

99 Tcm-HYNIC-Annexin V荷瘤小鼠肿瘤细胞凋亡显像研究

目的研究99Tcm-联肼尼克酰胺-膜联蛋白V(HYNIC-Annexin V)的制备及其在荷瘤小鼠体内生物分布特性和活体显像.方法用双功能螯合剂法,以99Tcm标记Annexin V,经高效液相色谱仪分离纯化并检测产物的标记率、放化纯及稳定性.建立荷S180肉瘤小鼠模型,于20～25g/只昆明种小白鼠右前腋皮下接种S180肉瘤细胞1周.荷瘤小鼠在环磷酰胺腹膜内化疗72h后,尾静脉注射7.4 MBq(200μl)99Tcm-HYNIC-Annexin V,分别于5、30min和1、3、6 h进行显像和体内生物分布测定.实验结果应用SPSS 12.0统计软件进行分析.结果 99Tcm-HYNIC-Annexin V的标记率达95%,放化纯为99%.荷瘤小鼠注射99Tcm-HYNIC-Annexin V后6 h显像,可见肿瘤组织放射性浓聚明显异常.体内生物分布实验示,注射显像剂后6 h肿瘤组织的放射性摄取最高[每克组织百分注射剂量率(%ID/g)为1.59±0.44],与其他时相比较,差异有显著性(P＜0.05).99Tcm-HYNIC-Annexin V主要浓聚于肾、肺和肝,经肾脏排泄;其在血液中清除速度快,注射后30 min,血液放射性摄取[(1.59±0.50)%ID/g]较注射后5 min时[(8.85±2.65)%ID/g]减少80%(P＜0.05).注射显像剂后6 h,肿瘤/肌肉放射性摄取比值(3.73±1.42)高于肿瘤/血液(2.80±0.54).结论 99Tcm-HYNIC-Annexin V活体细胞凋亡显像可应用于荷瘤小鼠模型,其临床应用有待进一步研究.     

钆双胺对^99Tc^m—MDP骨显像影响的实验研究

目的探讨MRI对比剂钆双胺注射液（欧乃影;Gd—DTPA—BMA）应用后对家兔^99Tc^m-MDP骨显像的影响。方法采用自身前后对照方法,实验组（注射欧乃影＋^99Tc^m-MDP）与自身对照组（注射生理盐水＋^99Tc^m-MDP）处理相隔7d。（1）取家兔5只,注射欧乃影或生理盐水后30min注射^99Tc^m-MDP,并于注射^99Tc^m-MDP后5、10、30、60、120、180、240和360min、24h时行骨显像,勾画ROI,计算靶／本底（T／B）值,观察家兔显像剂分布及代谢情况。（2）取家兔30只,按欧乃影或生理盐水与^99Tc^m-MDP的注射间隔（30、60、120、240和360min、24h）分为6组,每组5只。均于注射^99Tc^m-MDP后120min行骨显像,勾画ROI,计算T／B值。（3）采用TLC测定2种药物相互作用后在体内的放化纯差异。以配对t检验进行统计分析。结果注射欧乃影后30min再注射^99Tc^m-MDP,5min时肝、脾开始显影,其T／B比值120min时达最高峰（肝、脾分别为4．56±0．32和3．56±0．41）;而2组椎体24h时T／B值均达最大值（实验组为4．32±0．07,自身对照组为6．31±0．09）,但各时间点实验组均较自身对照组低。两药物注射间隔为30、60、120和240min时,可出现肝、脾异常显影,对应的实验组T／B（肝：2．47～4．22;脾：1．85～3．23）明显高于自身对照组（肝：1．52—1．58;脾：1．25～1．29）,但实验组椎体的T／B（3．08～4．28）则较自身对照组低（4．82～4．85）,以上差异均有统计学意义（t=7．750—31．916,均P〈0．05）。余时间间隔组,肝、脾未见明显摄取^99Tc^m-MDP。TLC曲线示,实验组在Rf为0—0．2处形成小峰,^99Tc^m-MDP放化纯降为（63．51±2．24）％。结论注射欧乃影后短时间内行^99Tc^m-MDP骨显像,肝、脾会出现异常摄取;间隔360min再行^99Tc^m-MDP骨显像可避免此现象发生。     

18F-FLT实验研究与临床应用进展

放射性核素标记的胸腺嘧啶类似物能够在一定程度上反映细胞增殖的状况,3′-脱氧-3′-18F-氟代胸苷(3′-deoxy-3′18F-fluorothymidine,18F-FLT)是此类药物中发展较为完善的一种示踪剂.18F-FLT PET通过反映胸苷激酶-1的活性而间接反映肿瘤细胞的增殖状况,有助于对肿瘤进行良恶性鉴别、疗效评估和预后判断,是一种具有良好应用前景的PET显像剂.     

99Tcm-His10-Annexin Ⅴ探测非小细胞肺癌细胞凋亡的实验研究

目的 探讨99Tcm标记带有10个连续组氨酸的膜联蛋白Ⅴ(His10-Annexin Ⅴ)探测荷非小细胞肺癌(NSCLC)裸小鼠模型化疗后肿瘤细胞凋亡的可行性.方法 用99Tcm直接标记His10-Annexin Ⅴ.荷H460 NSCLC肿瘤裸小鼠模型20只,按体表面积以100 mg/m2剂量紫杉醇化疗诱导,分成未治疗(对照)、化疗诱导后24,48,72 h共4组.99Tcm-His10-Annexin Ⅴ显像探测化疗前后肿瘤组织细胞凋亡,计算肿瘤/对侧正常肌肉组织放射性比值(T/NT),测定每克组织百分注射剂量率(%ID/g).以99Tcm-IgG显像为对照,确定肿瘤的非特异性摄取.用流式细胞术(FCM)测定肿瘤组织活化半胱氨酸天冬氨酸蛋白水解酶(Caspase-3),光学显微镜HE及原位末端标记法(TUNEL)染色测定凋亡指数.采用SPSS 12.0软件进行统计学处理,运用单因素方差分析和直线相关分析(Pearson).结果 99Tcm-His10-Annexin V放化纯为(98.01±1.67)%.注射99Tcm-His10-Annexin V后2 h即可得到清晰图像,化疗诱导组肿瘤部位可见明显的放射性浓聚,化疗后24,48,72 h组的T/NT值分别为2.63±0.76,3.41±0.90,3.85±0.62;对照组T/NT值为1.42±0.19,F值分别为12.064,23.322,70.177,P均<0.01.未治疗组肿瘤仅有少量放射性摄取,为(1.09±0.18)%ID/g,化疗后肿瘤摄取明显增加,24,48,72 h肿瘤摄取分别为(2.55±0.73)、(3.60±1.09)、(3.73±0.97)%ID/g,明显高于未治疗组(F值分别为18.733,20.624,35.626,P均<0.01).99Tcm-IgG显像化疗组及对照组肿瘤均未见明显放射性浓聚.未治疗组活化Caspase-3为(3.70±0.74)%,化疗后24,48,72 h分别为(23.46±2.23)%、(62.85±6.13)%、(70.44±6.09)%,3个化疗诱导组和未治疗组相比差异均有统计学意义(F值分别为354.610,459.438,591.052,P均<0.01).光学显微镜HE及TUNEL染色法发现,未治疗组细胞凋亡指数为(3.31±0.61)%,化疗后24,48,72 h细胞凋亡指数分别为(32.90±6.64)%、<70.42±7.54)%、(83.23±9.71)%,化疗诱导组与对照组细胞凋亡指数差异均有统计学意义(F值分别为98.627,393.215,337.386,P均<0.01).T/NT值、肿瘤组织放射性摄取与活化Caspase-3及细胞凋亡指数均有很好的相关性(r=0.847,0.833,0.774,0.850,P均<0.01).结论 99Tcm-His10-Annexin V显像可早期探测NSCLC化疗后细胞凋亡,进而早期预测和评价肿瘤治疗疗效.     

F-18 FDG PET in detecting uterine leiomyoma

PURPOSE: Uterine leiomyoma, benign tumors of the human uterus, are clinically apparent in about 25% of women and the most common solid pelvic tumors. The purpose of this study was to investigate the F-18 2-fluoro-2-deoxy-D-glucose (FDG) uptake in the uterine leiomyoma and assess the correlation between the intensity of FDG uptake in the uterine leiomyomas and menstrual cycle. METHODS: A total of 589 charts of healthy females examined by whole body FDG positron emission tomography (PET) for health screening examination were reviewed retrospectively. Twenty-two of them were suspected gynacecological tumors and referred to the department of gynacecology to ascertain the nature of the causes. Final diagnosis as uterine leiomyomas were made based on uterine sonography, pelvic computed tomography, or pelvic magnetic resonance imaging scans. We defined FDG uptake as Grade I when FDG uptake was less than liver uptake, Grade II when FDG uptake was equal to liver uptake, and Grade III when FDG uptake was greater than liver uptake. The menstrual cycle was recorded on the day of performing FDG PET in premenopausal women. RESULTS: The FDG uptake in the uterine region is Grade I in three of these 22 females (13.65%), Grade II in 16 (72.7%), and Grade III in 3 (13.65%). CONCLUSION: There is no significant correlation between the intensity of FDG uptake in the uterine leiomyomas and menstrual cycle (P=.914).     

18F-FDG PET in detecting metastatic infectious disease.

Timely identification of metastatic complications of bloodstream infections due to spreading of the microorganisms to distant sites, although critical, is often difficult. As 18F-FDG accumulates in activated leukocytes in infectious lesions, 18F-FDG PET represents a promising imaging technique in these patients. The aim of this study was to assess the value of 18F-FDG PET in detecting infectious foci in patients at high risk of metastatic complications. METHODS: The results of all 18F-FDG PET scans ordered because of suspected metastatic infection from October 1998 to September 2004 were analyzed retrospectively. These results were compared with conventional investigation techniques and the final clinical diagnosis. RESULTS: The results of 40 18F-FDG PET scans were evaluated. In 60% of all episodes, Gram-positive bacteria were cultured, in 18% Gram-negative bacteria, in 20% Candida spp., and in 3% the infection was polymicrobial. Metastatic complications were diagnosed in 75% of all episodes. A median number of 4 diagnostic procedures to search for metastatic infection had been performed before 18F-FDG PET was ordered. 18F-FDG PET diagnosed a clinically relevant new focus in 45% of cases and confirmed abnormalities already diagnosed in 30% of cases. The positive predictive value of 18F-FDG PET was 91% and the negative predictive value was 100%. CONCLUSION: 18F-FDG PET is a valuable imaging technique in patients at high risk of metastatic infectious disease, even when the results of other diagnostic procedures are normal.     

F-18 FDG PET in detecting renal cell carcinoma

Purpose: To assess the role of F-18 FDG imaging with a dual head coincidence mode gamma camera (Co-PET) in the detection of renal cell carcinoma (RCC) in patients with renal masses.

Material and Methods: An F-18 FDG Co-PET study was performed in 19 patients (7 F, 12 M; mean age 58.15±2.5 years, age range 45-79 years) with suspected primary renal tumors based on conventional imaging techniques, including computed tomography (CT) and ultrasonography (US) before nephrectomy or surgical resection of the mass.

Results: Histologically documented RCC was present in 15 patients. Of the 19 patients with suspected primary renal tumors, F-18 FDG Co-PET was true-positive in 13, false-negative in 2, true-negative in 3, and false-positive in 1 patient. Two angiomyolipomas and one renal mass due to infarction and hemorrhage showed a true-negative Co-PET result. The patient with false-positive FDG Co-PET study was diagnosed as xantogranulomatous pyelonephritis. Overall sensitivity, specificity, and accuracy of FDG Co-PET for RCC were 86% (13/15), 75% (3/4), and 84% (16/19), respectively. Positive predictive value for RCC was 92% and negative predictive value 60%.

Conclusion: These findings suggest that F-18 FDG Co-PET may have a role in the diagnostic evaluation of patients with RCC and primary staging of disease. Positive F-18 FDG study may be predictive of the presence of RCC. However, a negative study does not exclude the RCC.     

Evaluation of 18F-annexin V as a PET imaging agent in an animal model of apoptosis.

Annexin V is a 36-kDa protein that binds with high affinity to phosphatidylserine lipids in the cell membrane. Because one of the earliest measurable events in apoptosis is the eversion of phosphatidylserine from the inner membrane leaflet to the outer cell surface, annexin V has proven useful for detecting the earliest stages of apoptosis. METHODS: Annexin V was radiolabeled with 18F using N-succinimidyl-4-18F-fluorobenzoic acid chemistry, to a specific activity of 555-925 kBq/mug of protein. 18F-Annexin V (14.8-51.8 MBq) was administered intravenously to rats after pretreatment with cycloheximide (5 mg/kg) to induce liver apoptosis, and the injected rats were imaged by PET over 2 h. After imaging, rats were dissected and individual organs were weighed and counted. RESULTS: Pretreatment of rats with cycloheximide resulted in a 3- to 9-fold increase in uptake of 18F-annexin V in the liver of treated animals at 2 h, compared with controls. By morphologic analysis, treated livers showed a 3- to 6-fold higher level of apoptosis than controls, with higher levels also seen with longer exposure to cycloheximide. Terminal deoxynucleotide end-labeling (TUNEL) assays performed on liver slices showed that cycloheximide induced a 5- to 8-fold increase in the number of TUNEL-positive nuclei. These TUNEL results correlated with the uptake of 18F-annexin V in dissected liver tissue, with an r2 value of 0.89. Biodistribution analysis of normal rats showed highest uptake of 18F-annexin V in the kidneys and urinary bladder, indicating rapid renal clearance of 18F-annexin V metabolites. CONCLUSION: The PET data, the organ-specific uptake data from dissection, and the morphologic and TUNEL measures of apoptosis together indicate that 18F-annexin V binds specifically to apoptotic tissues in this model of chemically induced apoptosis in rat liver. The short physical half-life of 18F-annexin V and the rapid clearance of its metabolites to the urinary system suggest that 18F-annexin V will be useful in early assessment of the clinical response to cancer therapy in individual patients.     

Evaluation of diagnostic performance of 18F-FDG-PET compared to CT in detecting potential causes of fever of unknown origin in an academic centre

Determining the cause of fever of unknown origin (FUO) often proves challenging to attending physicians and the role of conventional imaging in this setting has been uncertain. In this retrospective study, we examined the role of fluorine-18 fluorodesoxyglucose-positron emission tomography ((18)F-FDG-PET) compared to computed tomography (CT) in diagnosing the potential etiology of FUO. To accomplish this task, we identified patients with FUO who underwent (18)F-FDG-PET for detecting the source of fever. Twenty-four patients (16 males and 8 females, age range = 17-80, mean age = 49.5) were examined with (18)F-FDG-PET of which 18 were also assessed with a diagnostic CT (within 3 weeks, mean interval = 7.5 days). The PET and CT findings were reviewed and the presence of focal (18)F-FDG uptake or gross CT lesions was considered a potential site causing FUO. Of patients who underwent PET alone, ? were reported as positive. Of the 18 who had both PET and diagnostic CT, PET was positive in 18 and CT was positive in only 7 cases. Of positive findings on PET, etiologies included infection (11), non-infectious inflammation (8), lymphoma (3), and other cancers (1). Of positive findings on CT, etiologies included infection (3), lymphoma (1), non-infectious inflammation (2) and other cancers (1). Importantly, we found no cases with positive CT and negative PET findings. In conclusion, accordingly to our findings, (18)F-FDG-PET appears to be of great value in assessing patients with FUO, especially when caused by infection or inflammation. Fluorine-18 FDG-PET is more sensitive than diagnostic CT in detecting and localizing diseased sites, and is the optimal imaging modality to evaluate patients with FUO.     

18F-氟脱氧葡萄糖PET全身显像时甲状腺意外瘤的检出及价值

随着正电子发射型体层显像应用的普及,甲状腺部位^18F-氟脱氧莆萄糖（^18F．FDG）的异常摄取被发现。在这部分意外瘤中,恶性肿瘤所占的比例较大。PET作为功能显像,不仅能够发现甲状腺意外瘤,同时也能对其良恶性有所区别。     

^18F-FDG符合线路显像在结直肠癌术后复发和（或）转移监测中的应用

目的评价^18F-脱氧葡萄糖（FDG）符合线路显像在结直肠癌术后复发和（或）转移监测中的价值。方法对56例结直肠癌术后6个月以上患者行^18F-FDG符合线路显像,经迭代法处理和重建,获得衰减校正后的断层图像,并与同期CT和癌胚抗原（CEA）检查结果进行对比。结果经再次手术病理、肠镜检查和随访观察56例患者中有33例发生复发和（或）转移,^18F-FDG符合线路显像诊断结直肠癌术后复发和（或）转移的灵敏度、特异性、阳性预测值、阴性预测值和准确性分别为81．8％（27／33）,87．0％（20／23）,90．0％（27／30）,76．9％（20／26）和83．9％（47／56）;CT分别为69．7％（23／33）,82．6％（19／23）,85．2％（23／27）,65．5％（19／29）和75．0％（42／56）;CEA的诊断效能分别为66．7％（22／33）,43．5％（10／23）,62．9％（22／35）,47．6％（10／21）和57．1％（32／56）。结论^18F-FDG符合线路显像监测结直肠癌术后复发和（或）转移有较大的临床应用价值,尤其在术后CEA水平升高的患者中,其诊断准确性较CT为高。     

乙型病毒性肝炎不同血清学模式前S1抗原、乙型肝炎病毒-DNA和肝功能指标的关系

目的检测乙型肝炎病毒（HBV）感染者不同血清学模式前S1抗原（pre-S1-Ag）、HBV～DNA和乙型肝炎抗原、抗体含量,结合血清肝功能（丙氨酸转氨酶ALT、天冬氨酸转氨酶AST）分析病毒性肝炎临床诊断、病情判断和预后。方法用酶联免疫吸附试验（ELISA）检测94例HBV感染者血清中pre-S1-Ag和乙型肝炎抗原、抗体,用荧光定量一聚合酶联反应（FQ-PCR）方法检测HBV-DNA含量,用全自动生化分析仪检测血清AI,T和AST指标。结果HBsAg（＋）、HBeAg（＋）、HBcAb（＋）模式的pre-S1-Ag检出率为79．4％,HBV—DNA检出率为97．1％,肝功能异常的为94．1％;HBsAg（＋）、HBeAb（＋）、HBcAb（＋）模式的Pre-S1Ag检出率为52．4％,HBV—DNA检出率为83．3％,肝功能异常的为88．1％;在HBsAg（＋）和HBcAb（＋）模式中pre-S1-Ag检出率为33．3％,HBV—DNA检出率为66．7％,肝功能异常的为33．3％。结论HBV-DNA检测在反映乙型肝炎病毒复制情况的检出率明显高于HBVpre—S1-Ag,但是HBVpre-S1-Ag检测成本低廉,与HBV—DNA的符合度较高,是对乙型肝炎“两对半”和HBV—DNA测定的重要补充和加强。乙型肝炎抗原、抗体及HBV-DNA联合pre-S1-Ag检测可以提高HBV的检出率,更能真实地反映出HBV在体内的复制情况,为乙型肝炎患者的诊断、治疗和预后判断提供依据。