戊型病毒性肝炎患者实验室检测方法的比较  

Comparison of laboratory testing methods for patients with viral hepatitis E

作　　者：李玲 张娜 王军成 贾沛洲 梁娇霞 朱琳茹 Li Ling;Zhang Na;Wang Juncheng;Jia Peizhou;Liang Jiaoxia;Zhu Linru(Clinical Laboratory of the 985 Hospital of the Joint Logistic Support Army,Taiyuan 030012,China;Laboratory of kidney transplantation center of Shanxi Second Provincial People's Hospital(Shanxi Provincial Occupational Disease Hospital),Taiyuan 030012,China;Purchasing Department of the 985 Hospital of the Joint Logistic Support Army,Taiyuan 030012,China)

机构地区：[1]中国人民解放军联勤保障部队第九八五医院检验科,太原030012 [2]山西省第二人民医院(山西省职业病医院)肾移植中心实验室,太原030012 [3]中国人民解放军联勤保障部队第九八五医院采购科,太原030012

出　　处：《实用医技杂志》2025年第2期120-124,I0002,共6页Journal of Practical Medical Techniques

摘　　要：目的对不同戊型肝炎病毒(HEV)检测方法进行比较,评估HEV尿液抗原检测方法在疾病诊断上的应用价值。方法2022—2024年临床诊断为戊型病毒性肝炎确诊病例21例,以健康人群20名作对照研究。分别利用化学发光法、荧光聚合酶链反应(PCR)法、酶联免疫吸附法、胶体金法对患者样本的病毒血清抗体、核酸、血液及尿液抗原进行比对分析,以评估不同方法的检测效果。结果尿液抗原和IgM抗体检出率最高,均为阳性18例,灵敏度85.7%;血液抗原阳性15例,灵敏度71.4%;核酸阳性16例,灵敏度76.2%;IgG抗体阳性9例,灵敏度42.9%。3例尿液抗原检测阴性,应为急性感染晚期或恢复期样本。4例样本尿液抗原和IgM检出结果不一致,分析表明尿液抗原在急性感染早期样本的检出方面表现更优于血清IgM。通过对20名健康对照样本的分析,尿液抗原、血清抗原和IgM分析特异性均为100%,病毒核酸特异性为95%,IgG特异性为85%。受试者工作特征(ROC)曲线分析结果显示,与血清抗原、病毒核酸和IgG相比,尿液抗原与IgM检测效果最佳。结论本文进一步验证尿液抗原检测是HEV现症感染的一个准确和特异的诊断方法,可以实现快速、无创检测,具有较高临床应用价值。Objective Compare different HEV detection methods and evaluate the application value of HEV urine antigen detection in disease diagnosis.Methods From 2022 to 2024,a study was conducted on 21 confirmed cases of hepatitis E virus and 20 healthy individuals as control.Comparative analysis of virus serum antibodies,nucleic acids,blood and urine antigens in patient samples was conducted using chemiluminescence,fluorescence PCR,enzyme-linked immunosorbent assay,and colloidal gold method to evaluate the detection effectiveness of different methods.Results The detection rates of urine antigen and IgM were the highest,with 18 positive cases and a sensitivity of 85.7%;15 cases were positive for blood antigens,with a sensitivity of 71.4%;16 cases were positive for nucleic acid,with a sensitivity of 76.2%;9 cases were positive for IgG,with a sensitivity of 42.9%.Three cases of negative urine antigen testing should be samples from the late stage or recovery period of acute infection.The results of urine antigen and IgM antibody detection in 4 samples were inconsistent,and the analysis showed that urine antigen performed better than serum IgM,in the detection of samples of early acute infection period.Through analysis of 20 healthy control samples,the specificity of urine antigen,serum antigen,and IgM analysis was 100%,viral nucleic acid was 95%,and IgG was 85%.The ROC analysis results showed that urine antigen and IgM had the best detection effect compared to serum antigens,viral nucleic acids,and IgG.Conclusion This article further verifies that urine antigen detection is an accurate and specific diagnostic method for current HEV infection,which can achieve rapid and non-invasive detection and has high clinical application value.

关 键 词：戊型肝炎 戊型肝炎病毒 戊型肝炎抗原 戊型肝炎抗体 

分 类 号：R512.6[医药卫生—内科学]