实时荧光定量PCR对乙肝DNA检测的影响及管理

Management of Real-time Fluorescence Quantitative PCR on Detection of Hepatitis B DNA

目的探讨实时荧光定量PCR对乙肝DNA检测的准确率,对影响因素进行分析,针对影响因素提出管理措施。方法选取2011年8月至2014年10月医院收治并已确诊的395例乙型肝炎病毒感染患者为研究对象,对本组395例患者空腹状态下抽取肘静脉血,进行实时荧光定量PCR检测,以临床诊断结果为对照标准,对比实时荧光定量PCR检测乙肝DNA结果差异,并对导致两者间差异的影响因素进行分析。结果通过实时荧光定量PCR技术检测乙肝DNA确诊374例,占94.7%,漏诊误诊21例,占5.3%,两者对比差异未见显著性差异(P>0.05)。影响检测结果的因素主要包括实验室条件、标本操作(标本抗凝血操作、标本贮存与溶血和血脂影响)以及核酸提取方法等。结论实时荧光定量PCR在HBV-DNA的检测中准确率较高,具有较高应用价值,但仍有一定的漏诊和误诊率,需加强管理,在多方面进行综合预防。

Objective To evaluate the accuracy of the hepatitis B DNA detection of real-time fluorescence quantitative PCR and to analyze the influencing factors, so as to put forward the management measures based on the influencing factors. Method From August 2011 to October 2014, 395 patients with diagnosed hepatitis B in our hospital were included in the study. The fasting blood was taken from cubital vein among 395 patients and real-time fluorescence quantitative PCR was conducted. We compared the results of the hepatitis B DNA detection of real-time fluorescence quantitative PCR with the results of clinical diagnosis to find out differences and analyzed the influencing factors of the differences. Results With the application of real-time fluorescence quantitative PCR, there were374 confirmed cases which accounted for 94.7%. Twenty one cases were missed diagnosis or misdiagnosis and accounted for 5.3%. There was no significant differences between the results of real-time fluorescence quantitative PCR and clinical diagnosis （P〉0.05）. The influencing factors of detection results included the conditions of the laboratory, operation of specimens （anticoagulation operation of specimens, specimen storage and the influence of hemolysis and lipid） and nucleic acid extraction methods. Conclusion The results of HBV-DNA detection of real-time fluorescent quantitative PCR have high accuracy rate and application value, but missed diagnosis or misdiagnosis also exist. Management of real-time fluorescent quantitative PCR should be strengthened in order to conduct integrated prevention in different aspects.