不同方法学测定乙型肝炎病毒核心抗体的阳性率及其定量检测意义的研究  

Analysis of the positive rate of different methodologies hepatitis B virus core antibody and study on its quantitative detection significance

作　　者：王红翠 林健聪 吴英松 董志宁 李志雄 

机构地区：[1]广州市达瑞生物技术股份有限公司,广东广州510665 [2]南方医科大学检验与生物技术学院,广东广州510515

出　　处：《分子诊断与治疗杂志》2018年第2期103-107,114,共6页Journal of Molecular Diagnostics and Therapy

基　　金：广州市科技计划项目(201504291007307)

摘　　要：目的对比分析不同方法学检测乙型肝炎病毒核心抗体(anti-HBc)的阳性率并探讨其定量检测的意义。方法临床随机收集健康查体者的标本400例,使用化学发光法和酶联免疫吸附测定法的anti-HBc试剂盒进行检测,对比分析其检测anti-HBc的阳性率。另外,对97例临床慢性乙型病毒性肝炎(chronic hepatitis B,CHB)患者跟踪随访,收集其药物治疗前后的血清标本并检测anti-HBc浓度,根据治疗前anti-HBc的浓度水平分成高低浓度两组,分析评价抗病毒治疗后不同浓度anti-HBc分组间患者乙型肝炎病毒e抗原(hepatitis B virus e antigen,HBeAg)的浓度变化。结果化学发光法的两种anti-HBc试剂盒检测健康查体者的anti-HBc的阳性率均为42.0%;酶联免疫吸附测定法anti-HBc检测试剂盒检测健康查体者标本,1∶30稀释后anti-HBc的阳性率为15.0%,原倍检测anti-HBc的阳性率为79.0%。高浓度组(≥9 000 IU/mL)治疗后HBeAg转阴率为20.83%;anti-HBc低浓度组(<9 000 IU/mL)治疗后HBeAg转阴率为2.04%。经卡方检验,anti-HBc高浓度组HBeAg转阴率比anti-HBc低浓度组HBeAg转阴率明显增高,差异具有统计学意义(P<0.05)。结论化学发光法测定anti-HBc的性能优于酶联免疫吸附测定法,可降低酶联免疫吸附测定法测定不稀释标本时的假阳性率和测定稀释标本时的漏检率。通过测定anti HBc的浓度水平,可预测慢性乙肝患者进行药物治疗的效果。Objective To analyze the positive rate of anti-HBc detected by using different methodol- ogies and to study on its quantitative detection significance. Methods 400 normal samples and 194 pre- and post-treatment serum specimens from 97 patients with chronic hepatitis B infection （CHB） were collected ran- domly, measured by chemiluminescence immunoassay （CLIA） and enzyme-linked immunosorbent assay （ELI- SA） anti-HBc detection kits, and the anti-HBc positive rate was analyzed statistically. Then, according to the baseline of anti-HBc titers, CHB patients were divided into high and low concentration groups, and the HbeAg seroconversion was examined in post-treatment patients receiving antiviral drug treatment. Results The anti- HBc positive rate of healthy individuals was 42.0% measured by chemiluminescence immunoassay from two anti-HBc kits, and it was 15.0% and 79.0% measured by ELISA kit from following 1 ： 30 dilution and without dilution respectively, The HBeAg seroconversion rates were 20.83% and 2.04% in the patients with high baseline anti-HBc titers （≥9 000 IU/mL） and low baseline anti-HBc titers （〈9 000 IU/mL） respectively. According to Chi-square test, the HBeAg seroconversion rates were significantly different between the 2 groups （P〈0.05）. Conclusion The anti-HBc positive rate of healthy individuals measured by chemiluminescence immunoassay anti-HBc kits, was lower than that of undiluted samples by ELISA, and the diluted specimens had great influence on the measure of anti-HBc positive rate by ELISA. The CHB patients with high baseline anti-HBc titers （≥9 000 IU/mL） had a greater HBeAg seroconversion rate than those with low baseline anti-HBc titers （〈9 000 IU/mL）.

关 键 词：乙型肝炎病毒核心抗体 定量检测 HBeAg血清学转化 抗病毒药物治疗 

分 类 号：R446.6[医药卫生—诊断学] R512.62[医药卫生—临床医学]