乙肝病毒血清标志物检测中临界值的探讨  

Inquiring into the cutoff value in detection of hepatitis virus B type serum marker

作　　者：翁志霞 

机构地区：[1]浙江省宁波市康宁医院检验科,315201

出　　处：《江西医学检验》2002年第6期327-328,共2页Jiangxi Journal of Medical Laboratory Sciences

摘　　要：目的探讨乙型肝炎病毒(HBV)血清免疫学标志物检测中决定阴阳性结果的临界值(COV)问题,提高结果的准确性。方法采用酶联免疫吸附试验(ELISA法)。对HBV的五项标志物进行检测。报告结果为阴性或阳性。COV值按操作说明书中的计算公式计算。结果共检测标本370例,HBsAg阳性57例,弱阳性标本8例,占总阳性率的14.0%。HBsAb阳性187例,.弱阳性标本65例,占总阳性的34.8%。HBeAg阳性15例,弱阳性标本2例,占总阳性率的13.3%。HBeAb阳性82例,弱阳性标本14例,占总阳性率的17.1%。HBcAb阳性112例,弱阳性16例,占总阳性率的14.3%。结论弱阳性标本常出现时阴时阳的结果。建议在报告阴、阳性结果同时报告COV值和标本OD值,COV值的变化直接影响结果的准确性,要尽量减少COV值的波动,使用统一的具有临床意义的临界值的质控血清进行严格的室内质控。有利于提高结果的准确性,也有利于临床诊断和治疗。Objective To improve diagnostic accuracy cutoff value(COV)by de-termining positive or negative results in detection of serum immunological marker of hepatitis B type virus.Method Five markers were detected with enzyme-linked im-munosorbent assay(ELISA)method.The reported results were positive or negative.COV was calculated according to formula in the operation guide.Result Three hundred and seventy patients were detected,of them57patients were HBsAg positive,8patients were HBsAg weakly positive.being14.0%of the total positive cases.One hundred and eighty seven patients were HBsAb positive,including65patients HBsAb weakly positive.Taking up34.8%of the total positive cases.Fifteen patients were HBeAg positive in-cluding2patients with HBeAg weakly positive.taking up13.3%of the total positive cases.Eighty twoo patients were HBeAb positive including14patients with HBeAb weakly positive,taking up17.1%of the total positive cases.One hundred and twelve patients with HBcAb positive including16patients with HBcAb weakly positive.Taking up14.3%of the total positive cases.Con clusion Changes in COV have a direct ef-fect on diagnostic accuracy,so fluctuation in COV should be decreased as far as possi-ble.Faintly positive samples often show negative results,and it is suggested that both COV and OD values,together with positive or negative results should be reported at the same time.Using quality-controlled serum of clinically significant COV has the ad-vantage both in improving diagnostic accuracy and treatment.

关 键 词：乙型肝炎病毒 血清标志物检测 临界值 酶联免疫吸附试验 准确性 

分 类 号：R373.21[医药卫生—病原生物学] R446[医药卫生—基础医学]