丙型肝炎病毒抗体及核酸测定的诊断效能分析

Diagnostic performance of HCV antibody and RNA Determination

目的探讨丙型肝炎病毒(HCV)感染患者HCV抗体(HCV-Ab)、HCV核糖核酸(HCV-RNA)水平的变化及其在诊断治疗中的意义。方法随机收集临床诊断为HCV感染患者血清,采用化学发光微粒子免疫检测法测定HCV-Ab,PCR-荧光探针法检测HCV-RNA,同时检测丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)。根据ALT、AST水平以及HCV-RNA水平分别分为两组,分析比较两组间各指标的变化。同时收集37例临床抗病毒治疗患者的血清,分析治疗前后各指标的变化。结果肝功异常组HCV-Ab、RNA载量对数值水平均高于肝功正常组(P<0.05)。HCV-RNA阳性组HCV-Ab、ALT、AST水平均高于HCV-RNA阴性组(P<0.05)。HCV-Ab、RNA载量对数值诊断丙型肝炎的ROC曲线下面积分别为0.990、0.838。连续观察病例治疗后ALT、AST、RNA载量对数值水平均较治疗前下降(P<0.05);而HCV-Ab治疗前后差异无统计学意义(P>0.05)。结论 HCV-Ab对于丙型肝炎的诊断效能优于RNA载量对数值。ALT、AST及HCV-RNA检测在丙型肝炎治疗监测过程中有重要临床意义。

Objective To explore changes of anti-HCV antibody and HCV-RNA in patients with HCV infection and its clinical significance in diagnosis and treatment of hepatitis C .Methods Serum samples from patients with HCV infection were collected . HCV antibodies were analyzed with a chemiluminescence micro-particle immunoassay method ,while a PCR-fluorescent probe meth-od was used to detect HCV-RNA .Concentrations of ALT and AST were also determined .Based on the concentrations of ALT , AST and HCV-RNA ,samples were divided into two groups respectively and the changes of different indicators were analyzed and compared .Meanwhile samples from 37 HCV-infected patients were collected continuously .Different indicators after treatment were compared with those before treatment .Results HCV-Ab and logarithm values of RNA load in the group with abnormal concentra-tions of ALT and AST were significantly higher than those in the normal group （P〈0 .05） .HCV-Ab ,ALT and AST concentrations in HCV-RNA positive group were significantly higher than those in HCV-RNA negtive group（P〈0 .05） .The areas under receiver operating characteristic curve of HCV-Ab and logarithm values of RNA load were 0 .990 and 0 .838 respectively .Concentrations of ALT ,AST and logarithm values of RNA load after treatment were significantly lower than those before treatment （P〈0 .05） while there was no significance between HCV-Ab level after treatment and that before treatment （P〉0 .05） .Conclusion The diagnostic performance of HCV-Ab is better than that of logarithm values of RNA load .Determination of ALT ,AST and HCV-RNA is of clinical importance in monitoring the effect of hepatitis C treatment .