基于不同检测方法的乙型肝炎病毒感染血清标志物模式分析

Analysis of HBV serological markers based on two different assays

目的对酶联免疫吸附试验(ELISA)和电化学发光法(ECLIA)检测乙型肝炎血清标志物[乙型肝炎病毒表面抗原(HBsAg)、乙型肝炎病毒表面抗体、乙型肝炎病毒e抗原、乙型肝炎病毒e抗体(抗-HBe)、乙型肝炎病毒核心抗体(抗HBc)]的结果进行回顾性分析,探讨两种方法检测乙型肝炎血清标志物结果的模式特征。方法从检验系统数据库中分别查询出2010年3～5月用ELISA检测的11 923例住院患者以及2011年3～5月用ECLIA检测的8 786例住院患者的乙型肝炎血清标志物结果。应用Excel和SPSS17.0软件对上述检测数据进行统计分析。结果在ELISA检测的11 923例患者中以及ECLIA检测的8 786例患者中,均发现男性HBsAg阳性率明显高于女性。2011年3月用ECLIA检测乙型肝炎血清学标志物后,出现4种新的模式,即3、4、5,1、2、3、5,1、3、4、5,1、2、3、4、5阳性模式,同时原先用ELISA检测可见的5种模式未能重现。ECLIA检测结果分析表明,2011年3、4和5月的住院患者之间2,2、5及2、4、5这3种模式阳性率差异均无统计学意义。2,2、5,2、4、5这3种阳性模式组抗-HBe定量中位数分别为167.9、136.8和245.3U/L,其差异有统计学意义(χ2=86.24,P<0.01)。结论应用ECLIA检测乙型肝炎血清学标志物可能出现不同于ELISA检测的结果模式,临床上在审核和解释乙型肝炎血清学标志物检测结果时需加以注意。

Objective To explore the characteristic pattern of five hepatitis B virus （HBV） serological markers by retrospectively analyzing the results detected by ELISA or ECLIA. Methods The data of HBV serological mark ers, including those detected by EL1SA from March to May in 2010 and those by ECI.IA from March to May in 2011, were obtained from laboratory information system database. All data were statistically analyzed by using Excel and SPSS17.0 programs. Results The prevalence of HBV surface antigen C（HBsAg） was significantly higher in male patients than in female patients. Four novel patterns of HBV serological markers were identified and five pat terns, which could be detected by ELISA, did not appear since ECLIA was used. ECIdA analysis demonstrated that there was not significant difference in the prevalence of 2, 25 and 245 patterns among the in-patient individuals from March to May in 2011. A significant difference was found, when the serum levels of HBV serfaee antibody C（HB- sAb） of the patients who were posilive only for HBsAb,those who were positive for HBsAb and HBV e antibody C （HBeAh） and those who were positive for HBsAb, HbeAb and HBV core antibody C（HBcAb） were compared（x^2 = 86.24 ,P〈0. 01）. Conclusion Different patterns of HBV serological markers would appear when different methods were utilized. More attention should therefore be paid to the interpretation of these results.