0～7d婴幼儿乙型肝炎表面抗原检测适用方法的选择  

Selection of the methods for detecting hepatitis B virus surface antigen in infants of 0-7 d

作　　者：郑岚 杨海鸥[1] 胡洁[1] 傅启华[1] 

机构地区：[1]上海交通大学医学院附属上海儿童医学中心检验科,上海200127

出　　处：《检验医学》2014年第10期1004-1006,共3页Laboratory Medicine

摘　　要：目的探讨选择适合于检测0～7d婴幼儿乙型肝炎表面抗原（HBsAg）的方法.方法收集上海儿童医学中心临床送检的0～7d婴幼儿血清标本137例,其中接受乙型肝炎疫苗接种者101例,未接受乙型肝炎疫苗接种者36例.用电化学发光法检测标本HBsAg,同时进行胆红素及血红蛋白测定.检测标本用酶联免疫吸附试验（ELISA）复测.通过查阅患儿病史资料,采用相关分析法分析注射乙型肝炎疫苗所致检测结果假阳性率的风险.结果接种疫苗组中55例为阳性,阳性率为54.5%;而未接种疫苗组中7例为阳性,阳性率为19.4%.风险性分析显示其比值比（OR）为4.953（95%可信区间1.987～12.350）.胆红素及溶血等因素并不影响假阳性的产生,而假阳性标本经ELISA复测后均为阴性.结论ELISA更合适用于0～7d婴幼儿HBsAg的检测,若用电化学发光法检测易造成-定的假阳性,应在注射乙型肝炎疫苗1周后检测,阳性结果则需在间隔数天后复测.Objective To investigate the proper method for detecting hepatitis B virus surface antigen （HBsAg） in infants of 0-7 d. Methods A total of 137 serum samples from infants of 0-7 d were collected from Shanghai Children＇s Medical Center. The 101 of 147 eases had been injected with hepatitis B vaccine, and the other 36 eases had not been injected. Eleetro-chemiluminescence inmmnoassay was used to detect HBsAg. The bilirubin and hemoglobin were detected sinmltaneously. All the samples were detected and reviewed by enzyme-linked inmmnosorbent assay- （ELISA）. Moreover, the medical history- and the percentage of hepatitis B vaccine injection were analyzed and calculated for false positive rate by correlation analysis. Results The 55 eases exhibited positive results in vaccine injection group, and the positive rate was 54.5%. A total of 7 eases in non vaccine injection group showed positive results, and the positive rate was 19.4%. Risk analysis showed that odds ratio （OR） was 4. 953 （95% confidence interval： 1. 987-12. 350）. Bilirubin and hemoglobin did not affect the false positivity. All of these false positive samples above were eolffirmed negatively by ELISA. Conclusions ELISA is the right way- to detect HBsAg in infants of 0-7 d. Hepatitis B vaccine injection could result in false positivity by eleetro-chemiluminescence inmmnoassay, which should be performed after 1 week, and should be repeated if false positive result exhibits.

关 键 词：乙型肝炎表面抗原 电化学发光 假阳性 

分 类 号：R446.61[医药卫生—诊断学]