ELISA法检测不同HBVM模式血清中乙型肝炎病毒表面抗原结果分析  

Analysis of the results of detecting HBsAg in serum of different HBVM patterns by ELISA

作　　者：杨柳莹[1] 陈曦阳[1] 凌攀[1] 杨烨[2] 赵仪[1] YANG Liuying;CHEN Xiyang;LING Pan;YANG Ye;ZHAO Yi(Sichuan Center for Disease Control and Prevention,Chengdu 610041,Sichuan Province,China;Chengdu Institution of Biological Products Company Limited,Chengdu 610023,Sichuan Province,China.)

机构地区：[1]四川省疾病预防控制中心,成都610041 [2]成都生物制品研究所有限责任公司,成都610023

出　　处：《职业卫生与病伤》2023年第3期137-141,173,共6页Occupational Health and Damage

摘　　要：目的分析各类乙型肝炎病毒血清学标志物(HBV markers,HBVM)模式下酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)检测乙肝表面抗原(HBsAg)结果的判断依据,为科学指导该人群防治乙型肝炎提供依据。方法收集体检人群ELISA法检测乙肝表面抗原(HBsAg)A值介于0.105~1.000的低值阳性样本及仅乙肝e抗体(HBeAb)阳性和(或)乙肝核心抗体(HBcAb)阳性样本,采用化学发光微粒子免疫分析(chemiluminesent microparticle immuno assay,CMIA)对血清中HBsAg进行定量复查,采用SPSS 22.0进行统计分析,以P<0.05为差异有统计学意义。结果共检测HBsAg A值介于0.105~1.000的阳性血清样本共50份,HBeAb阳性和(或)HBcAb阳性血清样本共311份。其中HBsAg模式和HBsAg-HBcAb模式中HBsAg的复检阳性率分别为25.0%和54.6%,显著低于HBsAg-HBeAbHBcAb模式中HBsAg的复检阳性率89.7%;HBcAb模式与HBeAb-HBcAb模式中HBsAg的复检阳性率分别为13.3%和45.5%,组间差异有统计学意义(χ^(2)=35.811,P<0.001)。HBeAb模式中HBsAg的复检阳性率为20%,与HBeAb-HBcAb模式中HBsAg的复检阳性率比较差异有统计学意义(χ^(2)=4.374,P=0.037)。通过ROC曲线寻找ELISA法检测HBeAbHBcAb模式中HBsAg的最佳诊断界值为0.021。结论ELISA法检测血清中HBVM,针对于HBsAg A值介于0.105~1.000的阳性血清,HBsAg-HBeAb-HBcAb模式中HBsAg真阳性的可能性大;针对于HBeAb-HBcAb模式,应根据HBsAg A值大小考虑HBsAg漏检的可能。可依据HBVM模式分类及HBsAg A值大小为该人群提供化验单结果解释及医学指导建议。Objective To analyze the judgment basis of the results of enzyme-linked immunosorbent assay(ELISA)in the detection of hepatitis B surface antigen(HBsAg)under the patterns of hepatitis B virus serological markers(HBVM),and to provide scientific guidance for the prevention and treatment of hepatitis B population.Methods The samples detected by ELISA from physical examination population with hepatitis B surface antigen(HBsAg)lowly positive and A value between 0.105-1,only hepatitis Be antibody(HBeAb)positive and/or hepatitis B core antibody positive(HBcAb)were collected,and the serum HBsAg of all samples above were quantitatively rechecked by chemiluminesent microparticle immuno assay(CMIA).SPSS 22.0 was used for statistical analysis,and the difference was statistically significant with P<0.05.Results A total of 50 serum samples with HBsAg positive and A value between 0.105-1,and 311 serum samples with HBeAb positive and/or HBcAb positive were detected.Among them,the retest HBsAg positive rates of HBsAg pattern and HBsAg-HBcAb pattern were 25%and 54.6%,respectively,significantly lower than that of HBsAg-HBeAb-HBcAb pattern with a positive rate of 89.7%.The retest HBsAg positive rates of HBcAb pattern and HBeAb-HBcAb pattern were 13.3%and 45.5%,respectively,and the difference among all groups was statistically significant(χ^(2)=35.811,P=0.000).The retest HBsAg positive rate of HBeAb pattern was 20%,which was significantly different from that of HBeAb-HBcAb pattern(χ^(2)=4.374,P=0.037).The best diagnostic threshold value of ELISA for detecting HBsAg of HBeAb-HBcAb pattern by receiver operating characteristic(ROC)curve was 0.021.Conclusions When HBVM in serum are detected by ELISA,for the positive serum with HBsAg A value between 0.105-1,HBsAg is more likely to be true positive in HBsAg-HBeAb-HBcAb pattern.For HBeAb-HBcAb pattern,the possibility of HBsAg missed detection should be considered according to the HBsAg A value.We can provide for this population with the interpretation of test sheet results and medical gui

关 键 词：乙型肝炎病毒血清学标志物 酶联免疫吸附试验 化学发光微粒子免疫分析 

分 类 号：R446.6[医药卫生—诊断学]