HCV抗原检测与HCV—RNA和HCV抗体检测的比较研究

Comparative Study on the Detection of HCV-Antigen, HCV-RNA and HCV-Antibody Detection

目的评价丙型肝炎病毒核心抗原（HCV抗原）、丙型肝炎病毒抗体（HCV抗体）及丙型肝炎病毒RNA（HCV—RNA）三种检测方法在丙型肝炎实验室诊断中的作用。方法HCV抗原采用双抗体夹心法；HCV-RNA采用实时荧光定量PCR技术（RT—PCR），HCV抗体采用酶联免疫技术（间接法），对44例HCV抗体阳性标本进行HCV抗原和HCV-RNA检测。结果在HCV抗体阳性标本中，HCV抗原阳性检出率为43．2％，HCV-RNA阳性检出率为82．5％；在HCV—RNA阳性标本中，HCV抗原阳性检出率为45．5％。结论三种丙肝标志物中，实时荧光定量PCR技术检测HCV-RNA是判断丙肝感染最可靠的方法而HCV抗原诊断丙肝，仍有54．5％的漏检率，其应用于临床还有距离。所以在没有条件应用实时荧光定量PCR技术检测HCV-RNA的医院，在用HCV抗原对HcV抗体阳性标本进行确认，来判断HCV既往感染或现症感染时，应结合肝功能指标及临床表现以明确诊断。

Objective To study the value of measurement of HCV antigen, HCV antibody and HCV-RNA in the clinical diag- nosis of Hepatitis. Methods HCV antigen would adopt double antibody Sandwiched method; HCV-RNA would employ the real-time fluorescence quantitative PCR technique, I-ICV antibody would use the technology of Enzyme-Linked Immunosor- bent Assay （ELISA） ,44 specimens of positive HCV antibody would be detected with HCV antigen and HCV-RNA meas- urement. Results Among the specimens of positive HCV antibody, the rate of positive HCV antigen was measured as 43.2% ;the rate of positive HCV-RNA was measured as 82.5%. Among the specimens of positive HCV-RNA, the rate of positive HCV antigen was measured as 45.5 %. Conclusion In the three kinds of Hepatitis markers,it was the most reliable method to judge whether infected with Hepatitis by using the real-time fluorescence quantitative PCR technique to measure HCV-RNA. If HCV antigen was used to diagnose Hepatitis, there was still 54. 5% rate of missed detection. Hence, there ex- ists a long distance from the application in the clinical practice. In the hospitals where it was impossible to employ the real- time fluorescence quantitative PCR technique to measure HCV-RNA,when confirming the specimens of positive HCV anti- body with HCV antigen and judging past exposure or present exposure to HCV,index of liver function and clinical manifestation should be combined to make a clear and definite diagnosis.