TRFIA法检测乙肝少见、罕见模式出现假阴性结果的原因  

To investigate the causes of false negative results in the detection of rare modes in hepatitis B virus by TRFIA

作　　者：叶巧国 薛国平 查长森 叶振望 卢德权 冯万初 

机构地区：[1]佛山市南海区第七人民医院检验科,广东佛山528200 [2]佛山市顺德区第一人民医院附属陈村医院

出　　处：《热带医学杂志》2017年第2期187-190,共4页Journal of Tropical Medicine

摘　　要：目的探讨时间分辨荧光免疫分析法(TRFIA)检测乙肝少见、罕见结果模式时出现假阴性结果的原因,并提出对策。方法选取2013年1月至2015年9月间,用TRFIA法进行两对半定量检测时出现的少见、罕见和可疑的阳性结果模式样本,同时采用胶体金法对乙肝表面抗原和乙肝e抗原进行检测,并用化学发光免疫分析法(CLIA)对上述样本进行两对半定量检测。结果在73例少见和可疑的阳性结果模式中,3+5:14例,2+3+5:8例,1+2+5:17例,1+2+4:9例,1+2:6例,高浓度的4+5:19例,其中乙肝表面抗原阳性有32例,乙肝e抗原阳性有22例;胶体金法检测结果:乙肝表面抗原阳性26例,乙肝e抗原阳性21例,并检出2例TRFIA法乙肝表面抗原结果为阴性的样本,但对低浓度的7例乙肝表面抗原和2例乙肝e抗原检测不出;而用CLIA法检测该73例两对半,模式中三个抗体的结果与TRFIA法并无太大的差异,但乙肝表面抗原检出38例(P<0.05),乙肝e抗原检出24例(P>0.05)。结论乙肝病毒变异等因素可致TRFIA法出现假阴性,胶体金法可起到一定的排查作用,但对低浓度的抗原或抗体有漏检;可用CLIA法对可疑样本进行定量复核,以利于临床的诊治。Objective To investigate the causes of false negative results in the detection of rare modes in hepatitis B virus bytime-resolued fluoroimmunoassay（TRFIA）and propose the countermeasures. Methods The samples of rare or suspiciousresults modes were selected as the research objects from January 2013 to September 2015. HBs Ag and HBe Ag were detectedby colloidal gold method,and two pairs of semi-hepatitis B were detected by chemiluminescence immunoassay（CLIA）method. Results 73 cases of rare or suspicious positive modes were detected by TRFIA：14 case of 3＋5,8 cases of 2＋3＋5,17 cases of 1＋2＋5,9 cases of 1＋2＋4,6 cases of 1＋2,and 19 cases of high concentration of 4＋5,including 32 cases ofHBs Ag（＋）and 22 cases of HBe Ag（＋）. Colloidal gold method results were as follows：26 cases of HBs Ag（＋）,21 casesof HBe Ag（＋）,including 2 cases of HBs Ag（-）detected by TRFIA,but 9 cases of low concentration of HBs Ag or HBe Aglost detection. The results of CLIA show that the three antibodies were not much difference between TRFIA and CLIA,butHBs Ag（＋）was detected in 38 cases（P〈0.05）,24 cases of HBe Ag（＋）（P〉0.05）. Conclusions HBV mutation and otherfactors might cause TRFIA false negative results,laboratory technician should pay attention to this problem. Colloidal goldmethod might play a role in the investigation,but lost detection in low concentration of antigen or antibody. CLIA methodcould be used to review the suspicious sample in order to facilitate the clinical diagnosis and treatment.

关 键 词：时间分辨荧光免疫分析 化学发光免疫分析 病毒变异 乙肝病毒标志物 假阴性 

分 类 号：R512.62[医药卫生—内科学]