3种免疫检验法检测乙型肝炎标志物在诊断乙型肝炎中的临床应用

Clinical application of three immunoassay methods to detect hepatitis B markers in the diagnosis of hepatitis B

目的探究化学发光免疫分析法(CLIA)、酶联免疫吸附试验法(ELISA)和时间分辨荧光免疫分析法(TRFIA)检测乙型肝炎标志物在诊断乙型肝炎中的临床应用价值。方法选取2018年1月至2020年11月于本院接受乙型肝炎筛查的148例患者作为研究对象,患者均行CLIA、ELISA和TRFIA检测,统计3种检测方法的乙型肝炎病毒表面抗原(HBsAg)、乙型肝炎病毒表面抗体(HBsAb)、乙型肝炎病毒e抗原(HBeAg)、乙型肝炎病毒e抗体(HBeAb)和乙型肝炎病毒核心抗体(HBcAb)的阳性检出率。同时,以病理活检作为金标准,比较3种检测方法在乙型肝炎中的诊断效能。结果CLIA检测显示,HBsAg阳性率为59.46%,HBsAb阳性率为56.08%,HBeAg阳性率为47.30%,HBeAb阳性率为18.92%,HBcAb阳性率为35.81%。ELISA检测显示,HBsAg阳性率为54.73%,HBsAb阳性率为45.95%,HBeAg阳性率为6.76%,HBeAb阳性率为21.62%,HBcAb阳性率为39.19%。TRFIA检测显示,HBsAg阳性率为51.35%,HBsAb阳性率为37.84%,HBeAg阳性率为31.76%,HBeAb阳性率为20.27%,HBcAb阳性率为62.84%。TRFIA诊断符合率(97.97%)、灵敏度(98.92%)均高于CLIA(91.22%、92.47%)和ELISA(86.49%、86.02%),差异有统计学意义(P<0.05);CLIA和ELISA诊断符合率、灵敏度比较差异无统计学意义。结论在乙型肝炎的乙型肝炎标志物检测中,TRFIA的诊断效能优于CLIA、ELISA,但3种检测方法均具有不同的优势,临床可根据患者的实际情况为其选择适宜的检测方法。

Objective To explore the clinical application value of chemiluminescence immunoassay(CLIA),enzyme linked immunosorbent assay(ELISA)and timeresolved fluorescence immunoassay(TRFIA)in detecting hepatitis B markers in the diagnosis of hepatitis B.Methods 148 patients who received hepatitis B screening in our hospital from January 2018 to November 2020 were selected as the research subjects,all patients were tested by CLIA,ELISA and TRFIA,the positive detection rates of hepatitis B virus surface antigen(HBsAg),hepatitis B virus surface antibody(HBsAb),hepatitis B virus e antigen(HBeAg),hepatitis B virus e antibody(HBeAb)and hepatitis B virus core antibody(HBcAb)were analyzed.Meanwhile,taking pathological biopsy as the gold standard,the diagnostic efficacy of the three detection methods in hepatitis B was compared.Results CLIA showed that HBsAg positive rate of was 59.46%,HBsAb positive rate of was 56.08%,HBeAg positive rate of was 47.30%,HBeAb positive rate of was 18.92%and HBcAb positive rate of was 35.81%.ELISA showed that the positive rate of HBsAg positive rate of was 54.73%,HBsAb positive rate of was 45.95%,HBeAg positive rate of was 6.76%,HBeAb positive rate of was 21.62%and HBcAb positive rate of was 39.19%.TRFIA showed that HBsAg positive rate was 51.35%,HBsAb positive rate was 37.84%,HBeAg positive rate was 31.76%,HBeAb positive rate was 20.27%and HBcAb positive rate was 62.84%.The diagnostic coincidence rate(97.97%)and sensitivity(98.92%)of TRFIA were higher than those of CLIA(91.22%,92.47%)and ELISA(86.49%,86.02%),and the differences were statistically significant(P<0.05).There was no significant difference in the diagnostic coincidence rate and sensitivity between CLIA and ELISA.Conclusion In the detection of hepatitis B markers,TRFIA is superior to CLIA and ELISA,but the three detection methods have different advantages,the appropriate detection method can be selected according to the actual situation of patients.