酶联免疫吸附法与光激化学发光法检测乙肝病毒的临床价值对比

Clinical value comparison between enzyme-linked immunosorbent assay and light initiated chemiluminescence assay for detection of hepatitis B virus

目的探讨酶联免疫吸附法与光激化学发光法检测乙型肝炎(乙肝)病毒的临床应用价值。方法84例疑似乙肝患者,均抽取清晨空腹静脉血,分为2份,分别进行光激化学发光法和酶联免疫吸附法检测。对比两种检验方法的乙肝两对半指标[乙肝表面抗原(HBsAg)、乙肝表面抗体(HBsAb)、乙肝e抗原(HBeAg)、乙肝e抗体(HBeAb)、乙肝核心抗体(HBcAb)]阳性检出率及对乙肝的诊断效果。结果光激化学发光法的HBsAg、HBsAb和HBeAg阳性检出率分别为86.90%、86.90%、85.71%,显著高于酶联免疫吸附法的75.00%、73.81%、72.62%,差异有统计学意义(P<0.05)。光激化学发光法的“小三阳”检出率60.71%显著高于酶联免疫吸附法的45.24%,差异有统计学意义(P<0.05)。实时荧光定量PCR检测乙肝病毒DNA显示:阳性72例、阴性12例。光激化学发光法对乙肝的诊断特异度91.67%高于酶联免疫吸附法的75.00%,但差异无统计学意义(P>0.05);光激化学发光法对乙肝的诊断敏感度98.61%、准确性97.62%显著高于酶联免疫吸附法的87.50%、85.71%,差异有统计学意义(P<0.05)。结论光激化学发光法用于乙肝病毒血清学检验的敏感度和准确性较高,可作为首选的检验方法,必要时可两者联合,进一步提升诊断准确性。

Objective To discuss clinical value of enzyme-linked immunosorbent assay and light initiated chemiluminescence assay for detection of hepatitis B virus.Methods In 84 patients suspected for hepatitis B,their fasting venous blood was collected in the morning and divided into 2 groups,which were further tested with enzyme-linked immunosorbent assay and light initiated chemiluminescence assay,respectively.The positive detection rates of five indicators for hepatitis B[hepatitis B surface antigen(HBsAg),hepatitis B surface antibody(HBsAb),hepatitis B e antigen(HBeAg),hepatitis B e antibody(HBeAb)and hepatitis B core antibody(HBcAb)]and diagnosis of hepatitis B were compared between the two assays.Results The positive detection rates of HBsAg,HBsAb and HBeAg in the light initiated chemiluminescence assay were 86.90%,86.90% and 85.71% respectively,which were higher than 75.00%,73.81% and 72.62% in the enzyme-linked immunosorbent assay;and the differences were statistically significant(P<0.05).The positive detection rate of HBsAg,HBsAb and HBcAb in the light initiated chemiluminescence assay was 60.71%,which was significantly higher than 45.24% in the enzyme-linked immunosorbent assay,and the difference was statistically significant(P<0.05).Real time quantitative PCR for detection of hepatitis B virus DNA showed:positive in 72 cases and negative in 12 cases.The diagnostic specificity of the light initiated chemiluminescence assay for hepatitis B was 91.67%,which was higher than 75%of the enzyme-linked immunosorbent assay,but the difference was not statistically significant(P>0.05).In the detection of hepatitis B,the light initiated chemiluminescence assay had a sensitivity of 98.61% and an accuracy of 97.62%,which were higher than 87.50% and 85.71% of the enzyme-linked immunosorbent assay,respectively,and the differences were statistically significant(P<0.05).Conclusion The light initiated chemiluminescence assay has higher specificity and accuracy in the serum test of hepatitis B virus.It can be used as the preferred option.If necessary,the two assays can be combined,so as to further improve the diagnostic accuracy.