两种方法对乙型肝炎HBc-IgG阳性结果的比较

Comparison on Hepatitis B HBc-IgG Positive Detection with Two Methods

目的探讨HBV标志物单项抗HBc-IgG（抗-HBc）阳性结果的临床意义。方法对微粒子酶免疫分析（MEIA）检测1 956例,ELISA检测432例住院患者的HBV标志物总抗-HBc阳性率和单项抗-HBc阳性率进行回顾性统计;对MEIA检测的96例单项抗-HBc阳性和134例HBV标志物全阴性住院患者的抗-HBs水平进行分析;对ELISA筛选的68例流行病学意义的单项抗-HBc阳性血清标本采用含10%小牛血清PBS进行稀释后,分别采用ELISA和MEIA检测抗-HBc并进行比较。结果ELISA检测抗-HBc流行病学意义和临床意义的总抗-HBc阳性率及单项抗-HBc阳性率分别为72.1%、16.3%和62.6%、7.6%。MEIA检测抗-HBc的总抗-HBc阳性率及单项抗-HBc阳性率分别为78.1%1、3.2%;MEIA检测HBV标志物单项抗-HBc阳性组和HBV标志物全阴性组的抗-HBs结果,差异有统计学意义（χ^2=86.9,P〈0.001）,ELISA筛选的68例单项抗-HBc阳性标本不同倍数稀释后ELISA和MEIA检测抗-HBc结果提示,未稀释或低倍稀释存在较高的非特异性反应,高倍稀释则存在较高的漏检率。结论不同方法单项抗-HBc阳性率存在一定的差异,单项抗-HBc阳性可作为乙肝病毒感染的依据,但存在一定比例的非特异性反应和假阴性,日常工作中ELISA检测抗-HBc以5-10倍稀释为宜。

Objective To discuss the positive result significance of HBc -IgG of HBV marker. Methods 1956 cases were detected with MEIA and 432 cases were detected with ELISA for hospitalized patients. The results were analyzed retrospectively. There were 96 HBc - IgG positive and 134 negative patient in MEIA compared. There were 68 cases with significance patient who were further detected with both methods. Results The total HBc - IgG and single positive in epidemic and clinical rate were 72.1%, 16.3% and 62.6%, 7.6% in ELISA detection. The results in MEIA detection were 78.1%, 13.2%. There was significant difference between total HBc - IgG positive rate and HBc - IgG negative group （ P 〈 0.001）. The varied diluted group in 68 cases of both methods showed that there was non- specific reaction in tan- diluted goup and mis- detection rate in high diluted cases. Conclusion There might be a difference between differenct detection methods in HBc - IgG. The HBc - IgG positive might be infected evidence of HB but with false negative rate and non- specific reaction. There should be diluted to 5 - 10 folds to detect the HBc - IgG in ELISA.