丙肝病毒核心总抗原定量检测的临床应用  

Clinical Application and Evaluation of Hepatitis C Virus Core Antigen Quantitative Assays

作　　者：曹军皓[1] 黄前川[1] 

机构地区：[1]广州军区武汉总医院检验科,武汉430070

出　　处：《现代检验医学杂志》2014年第2期108-109,114,共3页Journal of Modern Laboratory Medicine

摘　　要：目的 探讨定量检测丙型肝炎病毒核心总抗原（total HCV-cAg,tHCV-cAg）在丙型肝炎诊断中的作用及与病毒载量的相关性.方法 随机选取广州军区武汉总医院2010年10月-2013年3月丙肝患者血清标本66例,分别采用化学发光法检测血清tHCV cAg,酶联免疫法（ELISA）检测血清丙型肝炎游离核心抗原（free HCV-cAg,fHCV-cAg）及丙型肝炎抗体（hepatitis C virus antibody,HCV-Ab）,实时荧光定量PCR方法检测血清HCV-RNA,全自动生化分析仪检测血清谷氨酸氨基转移酶（ALT）.比较HCV-RNA,tHCV-cAg及fHCV-cAg阳性率差异,同时分析tHCV-cAg与HCV-RNA及ALT相关性,探讨tHCV-cAg联合检测HCV-Ab与HCV-RNA检测符合率.结果 66例丙型肝炎患者血清中,tHCV-eAg阳性率与HCV-RNA阳性率差异无统计学意义（χ^2=0.165,P＞0.05）;tHCV-cAg量与HCV-RNA呈正相关：logHCV Ag=0.81 log HCV RNA-1.31（γ=0.83,P＜0.05）.tHCV-cAg阳性率与fHCV cAg阳性率差异有统计学意义（χ^2 =12.53,P＜0.05）.HCV-cAg阳性组ALT值异常率与HCV-eAg阴性组ALT值异常率差异有统计学意义（P＜0.05,χ^2=17.47）.tHCV-cAg联合检测HCV-Ab符合率与HCV-RNA检测达100.00％.结论 化学发光法定量检测血清tHCV-cAg阳性率显著高于fHCV-cAg,与HCV RNA阳性符合率达96.08％ （49/51）,是丙型肝炎早期诊断的特异性指标.tHCV-cAg和HCV-RNA呈正相关性,与肝功能损害相关,是反映病毒的复制指标.tHCV-cAg联合检测HCV-Ab可减低丙型肝炎的漏诊率.Objective To evaluation of a total core antigen assay （tHCV-cAg） for the diagnosis of hepatitis C virus infection and exploration of the correlation between core antigen and viral load. Methods Randomly selected serum samples of 66 ca ses of hepatitis C patients from Wuhan General Hospital in October 2010 to March 2013,A total HCV-cAg levels in plasma were determined by a chemiluminescent microparticle immunoassay,free HCV-cAg （fHCV-cAg） and HCV Ah were detected by enzyme-linked immunosorbent assay,the HCV RNA titer was measured with real-time PCR, alanine ammotrans fe rase （ALT） was detected by using automatic biochemical analyzer. Results The positive rates of total HCV core antigen and HCV RNA were 74.24 % （49/66） and 77.27 % （51/66）, respectively. There was no significant statistical difference between two methods （χ^2 = 0. 165, P〉0.05）, HCV-Ag was strongly correlated with HCV RNA according to the following e quation： （log HCV-Ag）=0.81 （log HCV RNA）--1. 31 （y= 0. 83,P〈0. 05）. The positive rates of total HCV core antigen was remarkably higher than that of the free HCV-cAg （χ^2 = 12.53,P〈0.05）. The abnormal rate of A1.T in tHCV cAg positive group was higher than that of negative group （χ^2= 17.47,P%0.05）. A combination of HCV-Ab and tHCV-cAg showed agreement of 100% HCV-RNA. Conclusion In this study,tHCV-cAg concentrations were strongly correlated with HCV-RNA levels which were related to the liver injury. The newly developed automated HCV Ag assay could be used as an alternative test for HCV-RNA assays in some extent. Combination of anti HCV with tHCV cAg could efeetively reduce the miss diagnosis rate.

关 键 词：丙型肝炎核心总抗原 丙型肝炎游离核心抗原 丙型肝炎抗体 谷氨酸氨基转移酶 

分 类 号：R512.646.62[医药卫生—内科学]