Objective To study the serum of patients with different disease Hepatitis B antigen pre-S1 (HBVpre-S1) levels in patients with HBV serum markers, HBV-DNA of the clinical relevance, evaluation HB-Vpre-S1 the detection of hepatitis diagnosis value. Methods Used enzyme linked immunosorbent assay (ELISA) were conducted on 268 cases of the five serum HBV serum markers, Pre-S1 test. Automatic biochemical analyzer Lai liver function was detected, anddetected by fluorescence quantitative PCR HBV-DNA quantity. Results 196 patients with chronic hepatitis B (CH) patients, HBeAg (+) group, and HBeAg (-) group, Pre-S1(+)and HBVDNA(+)detection rate and the relative ratio of both high Pre-S1/HBsAg in HBeAg(-) group,the difference was significant,P <0. 01 ;and in HBeAg(-) group. HBeAb(-) group and HBeAb(+)group compared to, Pre-S1/HBsAg relative ratio was also significantly higher than HBeAb(+)group,P < 0. 05. In CH patients, mild,moderate and severe among the three groups of Pre-S1 (+)rate, HBVDNA and Pre-S1/HBsAg relative ratio,the difference was not statistically significant, and the relative ratio Pre-S1/HBsAg levels and liver inflammation grade. In the 72 cases of AH patients,Pre-S1/HBsAg the relative ratio and the severity of liver acute injury related to the ratio of AH relative decline in patients with earlier Pre-S1/HBsAg faster, shorter course of disease,better prognosis. Conclusion Pre-S1 can be used as a marker of HBV replication,and Pre-S1/HBsAg the relative ratio of height,in the diagnosis of hepatitis, AH has important prognostic value. Detection Pre-S1 can be combined to complement and improve the HBV less than five detection, particularly for HBeAg (-)or a variation of HBV infection to better reflect the state of viral replication and infectious. Key words: Hepatitis B virus; Before the S1 antigen; Odds ratio; HBV-DNA; Clinical laboratory techniques