自贡市食品及公共场所从业人员甲型、戊型肝炎病毒IgM抗体检测结果分析  

Analysis on IgM antibody detection results of hepatitis A virus and hepatitis E virus among employees from food and public places in Zigong City

作　　者：袁宗智 李群[1] 李科 闫国栋[1] 王红[1] YUAN Zong-zhi;LI Qun;LI Ke;YAN Guo-dong;WANG Hong(Zigong Center for Disease Control and Prevention,Sichuan 643000,China)

机构地区：[1]自贡市疾病预防控制中心,四川643000

出　　处：《医学动物防制》2022年第7期677-679,共3页Journal of Medical Pest Control

基　　金：四川省卫生计划和生育委员会科研课题(150259);传染病预防控制国家重点实验室开放课题(2016SKLID309)。

摘　　要：目的了解自贡市食品及公共场所从业人员甲型、戊型肝炎病毒抗体(HAV-IgM、HEV-IgM)检测情况,并分析采取异常谷丙转氨酶(ALT)筛查方式及快速法(胶体金法)检测可能造成的漏检。方法收集自贡市各区县实验室检测数据进行描述性比较分析。结果36090名体检者中ALT异常者1604人,异常率为4.44%。1604名ALT异常者中HAV-IgM阳性18人(1.12%),HEV-IgM阳性10人(0.62%),2019与2020年阳性标本比较后差异均无统计学意义(HAV-IgM:χ^(2)=0.32,P=0.57;HEV-IgM:χ^(2)=2.07,P=0.15)。1500名ALT正常体检者进行HAV-IgM、HEV-IgM抗体检测,HAV-IgM阳性9人(0.60%),HEV-IgM阳性7人(0.47%)。结论仅对ALT异常者进行HAV-IgM、HEV-IgM抗体检测很可能导致漏检,进而造成严重的公共卫生安全隐患。在抗体的检测上,酶联免疫吸附试验(enzyme linked immunosorbent assay,ELISA)和化学发光免疫分析(chemiluminescence immunoassay,CLIA)更值得临床推广应用。Objective To understand the antibody detections of hepatitis A virus and hepatitis E virus(HAV-IgM,HEV-IgM)among employees from food and public places in Zigong,and to analyze possible missed detection caused by abnormal alanine aminotransferase(ALT)screening technique and rapid detection(colloidal gold).Methods The data of laboratory detections in districts and counties of Zigong were collected for descriptive and comparative analysis.Results A total of 1604 out of 36090 subjects were found to have abnormal ALT with the abnormality rate of 4.44%.In the 1604 patients with abnormal ALT,18(1.12%)subjects were found to have positive HAV-IgM,10(0.62%)subjects were positive for HEV-IgM,and the differences after comparing positive samples collected in 2019 and 2020,respectively were not statistically significant(HAV-IgM:χ^(2)=0.32,P=0.57;HEV-IgM:χ^(2)=2.07,P=0.15).Totally 1500 subjects with normal ALT received antibody detections of HAV-IgM and HEV-IgM,and there were 9(0.60%)subjects with positive HAV-IgM and 7(0.47%)subjects with positive HEV-IgM.Conclusion Only the detections on patients with abnormal ALT for HAV-IgM and HEV-IgM antibodies may cause missed detection,and thereby lead to severe potential safety hazards for public health.Enzyme linked immunosorbent assay(ELISA)and chemiluminescence immunoassay(CLIA)are more worthy of clinical application.

关 键 词：病毒性肝炎 甲型肝炎病毒IgM抗体 戊型肝炎病毒IgM抗体 从业人员 漏检 胶体金法 酶联免疫吸附试验 化学发光免疫分析法 

分 类 号：R446.112[医药卫生—诊断学] R512.6[医药卫生—临床医学]