低水平HBsAg血清学模式及其临床价值

Serological model of low level HBsAg and its clinical value

目的探讨低水平乙型肝炎表面抗原(HBsAg)血清学模式及其临床价值。方法收集HBsAg≥0.05 IU/mL的阳性标本9972例,采用化学发光法定量检测乙型肝炎病毒(HBV)血清标志物。以HBsAg<100.00 IU/mL判定为低水平。初检HBsAg<0.50 IU/mL时,对标本进行高速离心后复检,以复检结果为最终结果。结果9972例HBsAg阳性标本中,HBsAg低水平1951例,占19.56%。HBsAg低水平标本检出HBV-M血清学模式11种,检出率≥1.00%的有5种,依次为“145”模式、“15”模式、“1245”模式、“135”模式、“1235”模式(97.59%)。抗HBc阴性在不同HBsAg水平均有检出,在HBsAg<1.00 IU/mL亚组最高(3.69%)。HBeAg阳性率随HBsAg水平的下降而下降,抗HBs阳性率随HBsAg水平的下降而升高。HBeAg对抗HBs阳性率存在显著影响。结论HBsAg低水平定量检测有其自身独有特点,提高检测灵敏度意义重大。

Objective To explore the serological model of low level HBsAg and its clinical value.Methods A total of 9972 positive samples with HBsAg≥0.05 IU/mL were collected.The serum markers of hepatitis B virus(HBV)were quantitatively detected by chemiluminescence method.The low level was determined by HBsAg<100.00 IU/mL.When the initial HBsAg<0.50 IU/mL,the samples were reexamined after high-speed centrifugation,and there examination result was the final result.Results Among the 9972 HBsAg positive samples,1951 cases(19.56%)had low level of HBsAg.There were 11 HBV-M serological models,and 5 models(97.59%)had detection rate≥1.00%,followed by"145"model,"15"model,"1245"model,"135"model and"1235"model.Anti-HBc negative was detected at different HBsAg levels,and the highest was found in the subgroup of HBsAg<1.00 IU/mL(3.69%).The positive rate of HBeAg decreased with the decrease of HBsAg,and the positive rate of anti-HBs increased with the decrease of HBsAg.HBeAg had a significant effect on the positive rate of anti HBs.Conclusion The low level of HBsAg quantitative detection has its own unique characteristics,so it is of great value to improve the detection sensitivity.