乙肝患者血清HBsAg与HBsAb双阳性的特殊模式  

Analysis on Special Mode of Patients with Positive HBsAg and Anti-HBs Simultaneously

作　　者：李朝晖[1] 曹友德[1] 

机构地区：[1]湖南省人民医院,湖南长沙410002

出　　处：《实用预防医学》2010年第11期2212-2214,共3页Practical Preventive Medicine

摘　　要：目的通过分析乙肝患者乙型肝炎病毒(HBV)血清标志物乙型肝炎表面抗原(HBsAg)与乙型肝炎表面抗体(HBsAb)同时阳性罕见模式的病例,探讨其存在原因及临床价值。方法应用ELISA法对乙肝感染者HBV标志物进行初筛,再采用微粒子酶免疫化学发光分析法(MEIA)检测其浓度;对HBsAg与HBsAb同时阳性者应用PCR方法定量检测HBV-DNA,并结合患者的临床特点进行综合分析。结果 HBsAg与HBsAb同时阳性的检出率为4.46%,检出率最高为重型肝炎(18.18%),其次为慢性肝炎(9.09%)和肝硬化(8.96%)。重型肝炎、慢性肝炎和肝硬化HBsAg与HBsAb同时阳性率明显高于无症状携带者和急性肝炎(P<0.01)。HBsAg高滴度组HBV-DNA病毒载量及阳性率明显高于低滴度组(P<0.01)。HBs-Ab值与HBV-DNA病毒载量间无明显相关性(P>0.05)。结论 HBsAg与HBsAb同时阳性的模式,是由多种原因引起,HBV亚型双重感染可能是主要原因。Objective To analyze the rare HBV marker model with HBsAg and HBsAb simultaneously positive in the sera of patients with hepatitis B virus infection,and to explore the existence cause and the clinical value of the rare model. Methods The HBsAg,anti-HBs,HBeAg,anti-HBe,and anti-HBc in the sera of patients with hepatitis B virus infection were detected by ELISA and MEIA.HBV-DNA in the patients with HBsAg and HBsAb simultaneously positive was determined by PCR,and their clinical characteristics were comprehensively analyzed. Result The detection rate of HBsAg and HBsAb simultaneously positive was 4.46%.The detection rate in severe hepatitis was the highest（18.18%）,followed by chronic hepatitis（9.09%） and chronic cirrhosis（8.96%）.The rates of HBsAg and HBsAb simultaneously positive in severe hepatitis,chronic hepatitis and chronic cirrhosis were significantly higher than those in hepatitis B virus carrier and acute hepatitis（P〈0.01）.The quantity and the positive rate of HBV-DNA in high-titer group were significantly higher than those of low-titer group（P〈0.01）.There was no significant correlation between HBsAb and the quantity of HBV-DNA（P〈0.05）. Conclusion The model with HBsAg and HBsAb simultaneously positive is caused by a variety of reasons,and the co-infection of HBV subtypes may be the main reason.

关 键 词：乙型肝炎 乙肝表面抗原 乙肝病毒核酸 ELISA PCR 

分 类 号：R512.62[医药卫生—内科学]