血清低水平HBsAg病人的分布及其乙肝两对半结果模式分析

Study on the Incidence of HBV Carriers with Low Levels of Serum HBsAg (<5μg/L) Among Routine Check-ups and the Distribution Pattern of Other HBV Markers in Them

目的:调查血清低水平HBsAg病人的分布状态及其乙肝病毒血清标志物(乙肝两对半)模式特征。方法:采用ELISA法对11420例首次健康体检者血清中的HBsAg、HBsAb、HBeAg、HBeAb及HBcAb进行定性分析,根据定值参比血清确定浓度在5μg/L以下的HBsAg阳性例数,并分析其相关乙肝病毒血清标志物模式。结果:11420例受检者中HBsAg阳性共1029例,其中HBsAg浓度在5μg/L以下者共312例,占总受检例数的2.73%,占HBsAg阳性人群的30.32%。在312例低水平HBsAg病人中,HBsAg含量<1μg/L者有147例(47.12%),(1～2)μg/L的有61例(19.55%),(2～5)μg/L的有104例(33.33%)。对低水平HBsAg人群的5项乙肝血清标志物检测共获得8种模式,以“HBsAg、HBeAb和HBcAb阳性”、“HBsAb和HBeAg阴性”模式为主(64.10%);HBsAg和HBcAb同时阳性者占87.18%;单纯HBsAg阳性者占10.90%;HBsAg与HBsAb同时阳性者占7.37%,且只出现在HBsAg1μg/L以下人群中。结论:低水平血清HBsAg人群不容忽视,提高HBsAg检测灵敏度有重要意义;同时检测相关乙肝病毒血清标志物,对于确定上述人群有帮助。

Objective To study the incidence of low HBsAg level HBV carriers among routine check - ups and the distribution pattern of other HBV markers in them. Methods Serum HBV markers （ HBsAg, HBsAb, HBeAg, HBeAb, HBcAb） were detected with ELISA in serum specimens from 11420 apparently healthy subjects. The distribution patterns of these markers were studied in detail in the HBsAg positive specimens with levels below 5μg/L. Results HBsAg was positive in 1029 of the 11420 specimens （9. 01% ）. Among the 1029 HBsAg positive specimens, levels of HBsAg were designated as low （below 5μg/L） in 312 cases （30. 32% ） ： below 1μg/L, 147/312 （47.12%） ; 1 ～ 2μg/L, 61/812 （ 19.55% ） and 2 ～5μg/L, 104/312（33.33% ）, The most prevalent combination of the markers was ： HBsAg, HBeAg, HBcAb（ ＋ ） ; HBsAb, HBeAb（ - ） （64.10% of the 312）. HBsAg was most often accompanied with a positive HBcAb （87.18% in this study） , which was more easily detected at low levels. Single HBsAg positive occurred in 10.9% of the 312 cases; HBsAg and HBsAb were beth positive in 7.37% of the 312 （all in those below 1μg/L）. Conclusion A substantial portion of HBsAg positive subjects had their HBsAg levels below 5p, g/L （ one third of them even below 1μg/ L）. As low levels of HBsAg were sometimes not easily detected, combined detection with other HBV markers, even with HBV - DNA or pre-s protein might be desirable in some specific cases.