丙肝病毒核心抗原的检测与RNA定量和谷丙转氨酶的相关性及临床意义

The Correlation and Clinical Significance of Detection of Core Antigen of Hepatitis C Virus with RNA Quantification and Glutamic Pyruvic Transaminase

目的探索丙肝病毒核心抗原(HCV-cAg)与RNA定量及谷丙转氨酶(ALT)的相关性,以指导临床应用。方法检测本院98例疑似丙型病毒性肝炎患者血清中HCV-cAg、RNA定量及ALT水平,评估检测结果的准确性及相关性。结果所有疑似患者血清中检测到HCV-RNA的患者87.76%(86/98),检测到HCV-cAg患者有82.65%(81/98),P>0.05。相对于HCV-RNA检测,HCV-cAg检测的灵敏度为94.19%。所有检测到HCV-cAg患者的血清中均能检测到RNA,HCV-cAg检测的特异性为100%。当病毒载量大于1.0×103IU/mL时,HCV-RNA定量与HCV-cAg水平高度正相关,r=0.93,P<0.0001。HCV-RNA定量或HCV-cAg水平分别与ALT水平高度正相关,r值分别为0.83、0.80,P<0.0001。结论HCV-cAg或HCV-RNA水平对于诊断丙型肝炎有相似诊断价值。HCV-cAg检测特异性高,灵敏度不及HCV-RNA。当病毒载量高时,HCV-RNA及HCV-cAg水平高度正相关,且分别与ALT水平均有高度正相关性。

Objective To explore the correlation between HCV core antigen(HCV-cAg),HCV-RNA test and alanine aminotransferase(ALT),so as to guide clinical applications.Methods HCV-cAg,RNA and ALT levels in 98 suspected patients with viral hepatitis C in our hospital were detected,and the correlation of the test values was evaluated.Results HCV-RNA was detected in 87.76%(86/98)of samples and HCV-cAg in 82.65%(81/98)of samples.Considering the HCV-RNA test as a gold standard,the sensitivity and specificity of HCV-cAg test were shown to be 94.19%and 100%,respectively.A high level of correlation was seen between HCV-RNA and HCV-cAg test among those patients with viral loads higher than 1.0×103IU/mL(r=0.93,P<0.0001).HCV-RNA quantitation or HCV-cAg level were highly positively correlated with ALT level,with r values of 0.83 and 0.80,respectively(P<0.0001).Conclusion:HCV-cAg or HCV-RNA test have similar diagnostic value in the diagnosis of hepatitis C.HCV-cAg detection has a high specificity and lower sensitivity than HCV-RNA.Both HCV-RNA and HCV-cAg levels are highly positively correlated with ALT levels.