自然人群乙型肝炎病毒感染的现况研究  

Current status of prevalence of hepatitis B virus infections in natural population

作　　者：潘小良[1] 宋朝晖[1] 梁巧米[1] 叶津[1] 包必南 

机构地区：[1]杭州市第一人民医院输血科,浙江杭州310006

出　　处：《中华医院感染学杂志》2016年第2期292-294,共3页Chinese Journal of Nosocomiology

基　　金：浙江省预防医学会医防整合基金资助项目(2015ZJYF-A013)

摘　　要：目的了解自然人群乙型肝炎病毒(HBV)感染现况及其不同检测指标的应用价值,为临床诊治提供参考依据。方法选取2008年1月-2009年12月医院住院、门诊及健康体检者共38 538人,应用Abbott i2000SR及配套试剂,对38 538份血样进行HBV血清学的定量检测;应用ROCHE LightCycler扩增仪对随机血样进行HBV-DNA检测。结果健康人群中HBsAg阳性371人,阳性率8.94%;HBsAg阴性的健康人群中HBcAb阳性1 215人,阳性率32.17%;HBcAb检测、HBsAg检测与HBV-DNA检测的一致性比较,其Kappa值分别为0.554、0.307,且HBcAb检测优于HBsAg检测(Z=9.17;P<0.01)。结论 HBV感染筛查指标中,HBcAb检测指标优于HBsAg的检测,HBsAg联合检测HBcAb指标更科学合理,可提高临床安全性,特别是临床用血、血液透析、各种侵入性诊疗及器官移植的安全性,降低HBV传播风险。OBJECTIVE To understand the current status of prevalence of hepatitis B virus（HBV）infections in natural population and observe the values of the detection indicators so as to provide guidance for clinical diagnosis and treatment.METHODS The hospitalized patients,outpatients,and healthy people,38 538 in total,were recruited as the study objects from Jan 2008 to Dec 2009,then the HBV serologic quantitative testing was performed for 38538 blood samples by using Abbott i2000 SR and accessory reagent,and the HBV-DNA detection was carried out for randomized blood samples by means of ROCHE LightCycler amplification system.RESULTS Among the health population,371 people were positive for HBsAg,with the positive rate 8.94%.Among the HBsAg-negative healthy population,1 215 people were positive for HBcAb,with the positive rate 32.17%.As compared with the consistency of the HBV-DNA detection,the Kappa values of the HBcAb detection and HBsAg were 0.554and0.307,respectively;the HBcAb detection was better than the HBsAg detection（Z=9.17;P 〈0.01）.CONCLUSION Among the screening indicators for the HBV infection,the HBcAb detection is superior to the HBsAg detection,and the joint detection of HBsAg and HBcAb is more scientific and reasonable,which may improve the clinical safety,especially the safety of clinical use of blood,hemodialysis,invasive procedures,and organ transplantation,and reduce the risk of spread of HBV.

关 键 词：病毒性肝炎 乙型肝炎病毒 乙型肝炎病毒表面抗原 乙型肝炎病毒核心抗体 

分 类 号：R512.62[医药卫生—内科学]