实时荧光定量HCV RNA与ALT检测在丙肝筛查中临床价值的研究  

The Clinical Value of HCV RNA and ALT in the Screening of Hepatitis C

作　　者：申宝玲 刘建华[1] 李静丹 SHEN Baoling;LIU Jianhua;LI Jingdan(Department of Laboratory Medicine, Beijing Rehabilitation Hospital, Capital Medical University, Beijing 100041, China;Department of Laboratory Medicine, Liangxiang Hospital, Fangshan District, Capital Medical University, Beijing 102401, China)

机构地区：[1]首都医科大学附属北京康复医院检验科,北京100041 [2]首都医科大学附属房山区良乡医院检验科,北京102401

出　　处：《标记免疫分析与临床》2021年第6期913-916,共4页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探讨抗-HCV抗体阳性时,实时荧光定量HCV RNA与ALT检测在丙肝筛查中临床价值的研究。方法回顾选择2019年1月至2019年12月首都医科大学附属房山区良乡医院收治的患者109例为研究对象,均留取外周静脉血,测定血清抗-HCV抗体、HCV RNA,丙氨酸氨基转移酶(ALT)水平。结果在收集的109例抗-HCV抗体阳性患者样本中,以HCV RNA为金标准作为丙型肝炎的诊断,HCV RNA阳性患者占20.2%(22/109),HCV RNA阴性患者占79.8%(87/109),两组样本经独立样本配对t检验,P值为0.006,差异有统计学意义(P<0.05),以HCV RNA检测为金标准,用SPSS 23.0软件对抗-HCV的S/CO值及ALT进行ROC曲线处理,HCV抗体S/CO值对丙型肝炎的ROC曲线下面积(AUC)为0.851,ALT对丙型肝炎的ROC曲线下面积(AUC)为0.831。结论HCV RNA阳性患者ALT平均值明显高于HCV RNA阴性患者的ALT平均值。抗-HCV的S/CO值及ALT对于丙型肝炎的筛查都有一定的价值,且抗-HCV抗体优于ALT的筛查。临床上,患者筛查丙型肝炎抗体阳性时,可同时进行ALT的检测,可为丙型肝炎早期诊断提供依据,以免延误治疗时机。Objective To explore the clinical value of real-time fluorescent quantitative HCV RNA detection and ALT in the screening of hepatitis C when the anti-HCV antibody is positive.Methods 109 patients admitted to Fangshan District Liangxiang Hospital affiliated to Capital Medical University from January,2019 to December,2019 were selected as the research objects.Serum anti-HCV,HCV RNA,alanine aminotransferase(ALT)were measured in all subjects.Results Among 109 cases of anti-HCV positive patients,HCV RNA was used as the gold standard for the diagnosis of hepatitis C.HCV RNA positive patients accounted for 20.2%(22/109),while HCV RNA negative patients accounted for 79.8%(87/109).The two groups of samples were analyzed by independent sample paired t test,and P value was 0.006,indicating that the comparison was statistically significant(P<0.05).With HCV RNA detection as the gold standard,using SPSS23.0 software for anti HCVS/CO value and ALT for ROC curve processing,HCV antibody S/CO value area under the ROC curve(AUC)for hepatitis C was 0.851,and ALT area under the ROC curve(AUC)for hepatitis C was 0.831.Conclusion The average value of ALT in patients with positive anti-HCV antibody screened by real-time PCR is significantly higher than that in patients with negative HCV RNA.The S/CO value of anti-HCV and ALT have a certain value for the screening of hepatitis C,and anti-HCV is higher than ALT.In clinical practices,it is necessary to determine whether patients are infected or in the window period by screening for both HCV antibody positive and ALT at the same time.The combined detection of two indexes can provide the knowledge basis for the early diagnosis of hepatitis C,so as not to delay the treatment.

关 键 词：丙型肝炎病毒 实时荧光定量PCR 抗-HCV抗体 ALT 

分 类 号：R512.63[医药卫生—内科学]