三种诊断方法在丙型肝炎中的应用  

Application of three kinds of methods of diagnosis in Hepatitis C

作　　者：符月春[1] 邹碧姬[1] 陈文思[1] 

机构地区：[1]中山大学附属第三医院检验科,广州510630

出　　处：《国际医药卫生导报》2014年第19期3003-3006,共4页International Medicine and Health Guidance News

摘　　要：目的探讨三种检测方法作为临床筛选和诊断丙型肝炎的的优缺点。方法随机收集71例丙肝患者血清作为阳性组，63例非丙肝患者血清作为阴性组，采用PCR-荧光探针法检测HCV RNA，同时采用CMIA法和ELISA法检测Anti—HCV。结果阳性组中，PCR-荧光探针法灵敏度为87．32％，CMIA为100％，ELISA为97．18％；经卡方检验分析，χ^2=4．95，两种Anti—HCV检测方法均与PCR-荧光探针法检测结果的差异有统计学意义（P〈0．05）；而两种Anti—HCV检测方法之间差异无统计学意义（P〉0．05）；阴性组中，HCV RNA特异度为100％，CMIA为95．23％，ELISA为98．41％；经χ^2检验分析，χ^2=3．84，三种诊断方法特异度的差异无统计学意义（P〉0．05）。结论三种方法各有利弊，在诊断丙型肝炎方面，本文推荐采用其中一种抗体检测方法与PCR-荧光探针法联合检测；在疗效观察方面，本文推荐PCR-荧光探针法；在大规模体检时，考虑经济因素，本文推荐ELISA；在Anti—HCV检测结果为阳性，或者两种Anti—HCV检测方法结果不一致时，需联合HCV RNA检测。Objective To explore the advantages and disadvantages of three methods for clinical screening and diagnosis in Hepatitis C. Methods 71 cases of Hepatitis C patients for experimental group , while 63 negative samples excluding Hepatitis C as control group. Antibody Hepatitis C Virus （Anti-HCV） was detected by PCR-fluorescent probe ,chemiluminesent microparticle immunoassay（CMIA） and enzyme linked immunosorbent assay（ELISA） respectively. Results In the positive group, the sensitivity of PCR-fluorescent probe was 87.32%, CMIA was 100%, ELISA was 97.18%; Analyzed by chi-square test, χ^2=4-95, the difference between PCR-fluorescent probe and other kinds of methods was statistically significant （P 〈0.05）, while no significant difference between CMIA and ELISA （P〉 0.05）. In control group, the specificity of PCR- fluorescent probe was 100%, CMIA 95.23%, ELISA 98.41%, respectively; Analyzed hy χ^2 test, the specificity of three methods had no statistically significant （P〉 0.05）, χ^2=3.84. Conclusions There were advantages and disadvantages for three methods in the diagnosis of Hepatitis C. One of the methods in CMIA and ELISA combined with PCR-fluoreseence probe was recommended for diagnosing Hepatitis C. If you are going to monitor the treatment effect, PCR-fluorescence probe must be used; However, ELISA is widely used in most of the hospitals for the economic reasan. When the result of Anti-HCV was suspicious or positive, PCR was needed to be detected to conform its authenticity.

关 键 词：丙肝肝炎病毒 抗丙肝病毒抗体 PCR-荧光探针法 化学发光微粒子免疫分析 酶联免疫吸附试验 

分 类 号：R446.6[医药卫生—诊断学]