血清标志物乙型肝炎核心抗体和乙型肝炎E抗原及乙型肝炎表面抗原与乙型肝炎病毒-DNA定量检测对乙型肝炎的临床诊断

Clinical diagnosis of hepatitis B by quantitative detection of serum markers of hepatitis B core antibody and hepatitis B e antigen and hepatitis B surface antigen and hepatitis B virus

目的探究血清标志物乙型肝炎核心抗体(HBcAb)、乙型肝炎E抗原(HBeAg)、乙型肝炎表面抗原(HBsAg)与乙型肝炎病毒(HBV)-DNA定量检测对乙型肝炎临床诊断价值。方法选取2021年1-12月徐州矿务集团总医院收治的117例乙肝住院患者作为研究对象,以乙肝血清标志物情况分为A组[大三阳,即HBsAg(+)、HBeAg(+)、HBcAb(+),n=34]、B组[小三阳,即HBsAg(+)、HBcAb(+)、乙型肝炎E抗体(HBeAb)(+),n=59]、C组[HBsAg+HBcAb(+),n=10]、D组[乙型肝炎表面抗体(HBsAb)+HBcAb(+),HBsAb+HBeAb+HBcAb(+),HBe-Ab+HBcAb(+),HBcAb(+),HBsAb(+),HBsAg(+),n=14]。比较4组HBV-DNA阳性检出率及定量分析结果,比较HBV-DNA与HBeAg、HB-sAg、HBcAb及联合检测的阳性检出率。结果4组HBV-DNA阳性检出率、HBV-DNA水平比较差异有统计学意义(P<0.05);A组HBV-DNA阳性检出率、HBV-DNA水平均高于B组、C组、D组,B组HBV-DNA水平高于D组,但低于C组,C组高于D组,差异有统计学意义(P<0.05),其他HBV-DNA阳性检出率两两比较差异无统计学意义。HBV-DNA、HBeAg、HBsAg、HBcAb及联合检测阳性检出率比较差异有统计学意义(P<0.05);HBV-DNA阳性检出率高于HBeAg,低于HBsAg、HBcAb,且HBeAg低于HBsAg、HBcAb及联合检测,HBsAg低于HBcAb、联合检测,差异有统计学意义(P<0.05),其余两两阳性检出率比较差异无统计学意义。结论大三阳患者的HBV-DNA检测水平最高,联合诊断检出率高于HBV-DNA、HBeAg、HbsAg单独诊断,临床对意思乙型肝炎患者可考虑应用联合诊断。

Objective To explore the clinical diagnostic value of quantitative detection of serum markers of hepatitis B core antibody(HBcAb),hepatitis B e antigen(HBeAg),hepatitis B surface antigen(HBsAg)and hepatitis B virus(HBV)-DNA in hepatitis B.Methods 117 hospitalized pa-tients with hepatitis B in Xuzhou Mining Group General Hospital from January to December 2021 were selected as the reasearch subjects,they were divided into the group A(HBsAg[+],HBeAg[+],HBcAb[+],n=34),the group B(HBsAg[+],HBcAb[+],Hepatitis B e antibody[HBeAb][+],n=59),the group C(HBsAg+HBcAb[+],n=10),the group D(hepatitis B surface antibody[HBsAb]+HBcAb[+],HBsAb+HBeAb+HBcAb[+],HBe-Ab+HBcAb[+],HBcAb[+],HBsAb[+],HBsAg[+],n=14).The positive detection rate and quantitative analysis results of HBV-DNA among the four groups were compared,and the positive detection rates of HBV-DNA,HBeAg,HBsAg,HBcAb and combined detection were compared.Results There were significant differences in the positive detection rate of HBV-DNA and the level of HBV-DNA among the four groups(P<0.05);the positive detection rate of HBV-DNA and the level of HBV-DNA in the group A were higher than those in the group B,the group C and the group D,the level of HBV-DNA in group B was higher than that in the group D,but lower than that in the group C,the level of HBV-DNA in group C was higher than that in group D,and the differences were statistically significant(P<0.05),there was no significant difference in the positive detection rate of other HBV-DNA.There were significant differences in the positive detection rates of HBV-DNA,HBeAg,HBsAg,HBcAb and combined de-tection(P<0.05);the positive detection rate of HBV-DNA was higher than that of HBeAg,lower than that of HBsAg and HBcAb,and HBeAg was lower than that of HBsAg,HBcAb and combined detection,HBsAg was lower than that of HBcAb and combined detection,the differences were statis-tically significant(P<0.05),there was no significant difference in the positive detection rate between the other two groups.Conclusion The detection rate of combined diagnosis was higher than that of single diagnosis of HBV-DNA,HBeAg and HbsAg,clinically,combined diagnosis can be consid-ered for patients with hepatitis B.