1例不同方法学对甲、戊型肝炎病毒抗体检测结果的差异分析

Analysis on Difference of Detection Results of Hepatitis A and E Virus Antibody by Different Methods in One Case

目的:分析1例不同方法学对甲、戊型肝炎病毒抗体检测结果的差异。方法:选取2021年9月广西中医药大学附属瑞康医院收治的1例初次检测及复查结果均显示为甲型肝炎病毒(HAV-IgM)弱阳性、戊型肝炎病毒(HEV-IgM)阳性的患者作为研究对象。患者初次采用酶联免疫吸附法检测,结果显示HAV-IgM弱阳性、HEV-IgM阳性,复查结果与初次检测结果保持一致;随后前往其他医院检测(化学发光法),结果均为阴性。为探讨检测结果矛盾的原因,分别采用多家公司试剂盒及免疫印迹法进行验证。结果:该例患者HAV-IgM为阳性,初检及复查的安图结果与实验室罗氏验证的结果一致;HEV-IgM为阴性,安图结果与免疫印迹结果一致。结论:HAV-IgM、HEV-IgM具有多种不同方法学试剂,实验室应根据自身临床实验室的条件选择适合的方法学开展项目检测。针对异常结果应积极与临床沟通,结合临床症状判断,或采用准确度更高的方法学复查,并建议受检者定期复检。

Objective:To analyze the difference of detection results of different methods in hepatitis A and E virus antibody.Methods:In September 2021,one patient admitted to Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine was selected as the study subject,the patient was weakly positive for hepatitis A virus(HAV-IgM)and positive for hepatitis E virus(HEV-IgM).The patient was initially detected with enzyme-linked immunosorbent assay and results showed HAV-IgM weakly positive and HEV-IgM positive.The retest results were consistent with the initial test results.Subsequently the patient visited other hospitals for tests(chemiluminescence method)and results were negative.In order to explore the reasons for the contradiction of the test results,kits from multiple companies and western blot method were used for verification.Results:The patient was positive for HAV-IgM,and the Autobio results of the initial test and retest were consistent with the results of Roche verification in the laboratory.HEV-IgM was negative,and the Autobio results were consistent with the western blot results.Conclusion:There are many different method and reagents for the detection of HAV-IgM and HEV-IgM.The laboratory should select the appropriate method for tests according to the conditions of its own clinical laboratory.For abnormal results,it is necessary to active communicate with the clinic and judge based on the clinical symptoms,or use more accurate methodology for retest and suggest regular reexamination.