1岁以下婴幼儿血清乙肝病毒血清标志物检测结果分析  

Epidemiological study on the HBV-M results in infants under 1 year of age in Xi'an area

作　　者：安哲[1] 李思鹏[1] 张妮[1] 董炜[1] 孟昊[1] 刘海龙[1] 周源 郭智 秦瑞鸿 朱幻歌 宋琳岚 AN Zhe;LI Si-peng;ZHANG Ni;DONG Wei;MENG Hao;LIU Hai-long;ZHOU Yuan;GUO Zhi;QIN Rui-hong;ZHU Huan-ge;SONG Lin-lan(Department of Clinical Laboratory,the the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an,Shaanxi 710004,China)

机构地区：[1]西安交通大学第二附属医院检验科,陕西西安710004

出　　处：《中华全科医学》2022年第1期99-103,共5页Chinese Journal of General Practice

基　　金：陕西省重点研发计划项目(2018SF-152);西安交通大学第二附属医院人才培养专项科研青年基金[YJ(QN)201534]。

摘　　要：目的回顾性分析1周岁前婴幼儿血清乙肝病毒血清标志物检测结果及其特征。方法以2019年1-11月在西安交通大学第二附属医院临床实验室检测乙肝病毒血清标志物(hepatitis B virus markers,HBV-M)的815例1岁以下婴幼儿和219例新生儿母亲为研究对象。将1岁以下内婴幼儿按月龄分为3组:7~11月龄组、1~6月龄组、<1月龄组。HBV-M定量检测采用化学发光法,检测仪器采用美国雅培公司的Alinity化学发光免疫分析仪。所有HBsAg≥0.05 IU/mL的样本均高速离心后二次复检,并以二次复检结果作为最终结果。结果3组不同年龄婴幼儿的HBV-M模式种类分别是5、7、10种,3组婴幼儿的HBsAg阳性检出率分别是:0.00%、0.47%、6.66%,3组婴幼儿的抗HBs阳性检出率分别是:94.29%、84.65%、66.06%,3组婴幼儿的抗HBc阳性检出率分别是:6.67%、20.47%、27.27%;219对母子检测结果,8例HBsAg阳性母亲所生新生儿HBsAg阳性率为0.00%,76例HBV-M全阴性结果的一致率为85.53%;抗HBs、抗HBc、抗HBe的一致率分别是100.00%、95.00%、77.27%;31例HBsAg阳性婴幼儿HBV-M的主要特征:其母亲HBsAg阴性;HBsAg水平均值为0.19 IU/mL(0.05~0.54 IU/mL);抗HBc阴性;定期随访HBsAg可阴转;疫苗和新生儿黄疸可能是其假阳性的主要原因;检出时间不超过疫苗接种后10 d。结论7~11月龄婴幼儿HBsAg阳性率最低,抗HBs阳性率最高,表明当前疫苗预防效果良好;<1月龄新生儿HBV-M受多种因素影响,来自母体的抗原抗体是主要的干扰因素;该年龄段HBsAg阳性主要见于1~10日龄新生儿,定期随访可阴转。Objective To analyse the results and characteristics of hepatitis B virus markers(HBV-M)in infants before 1 year of age retrospectively.Methods From January 2019 to November 2019,815 infants and 219 mothers with HBV-M were examined in the clinical laboratory of the Second Affiliated Hospital of Xi'an Jiaotong University.The infants were divided into three groups:group 1,which included infants aged 7-11 months;group 2,which included infants aged 1-6 months;and group 3,which included infants aged below 1 month.The HBV-M quantitative test was performed by chemiluminescent immunoassay with Abbott's Alinity immunoassay instrument.All samples of HBsAg were centrifuged at high speed and rechecked,and the rechecked results were taken as the final results.Results The positive rates of HBsAg were 0.00%,0.47%and 6.66%,respectively,in the three groups.The positive rates of anti-HBs in the three groups were 94.29%,84.65%and 66.06%,respectively.The positive rates of anti-HBc in the three groups were 6.67%,20.47%and 27.27%,respectively.The HBsAg positive rate was 0%in infants born from 8 HBsAg-positive mothers.The consistency rate was 85.53%between 76 HBV-M-negative mothers and their infants,and consistency rates of anti-HBs,anti-HBc and anti-HBe were 100.00%,95.00%and 77.27%,respectively.The main features of HBV-M in 31 HBsAg-positive infants were:HBsAg negative in their mothers,HBsAg level 0.19 IU/mL(0.05-0.54 IU/mL),anti-HBc negative,regular follow-up HBsAg can turn negative,HBV vaccine and NHB may be the main reason for false positive,the detection time does not exceed 10 days after vaccination.Conclusion The HBSAG positive rate and anti-HB positive rate of 7-11-month-old infants are the lowest,which indicates that the protective effect of HBV vaccine is good at present HBsAg was mainly found in 1-10-day-old newborns,which could turn negative during regular follow-up.

关 键 词：婴幼儿 乙肝病毒血清标志物 乙型肝炎表面抗原 疫苗 

分 类 号：R512.62[医药卫生—内科学] R446[医药卫生—临床医学]