血清乙肝表面抗原检测弱反应结果的确认方法及评价

Evaluation of three different methods in confirming the weakreactive results of HBsAg in serum

目的探讨血清HBsAg检测弱反应性结果确认方法。方法收集经AxSYM检测HBsAg浓度约在0.5μg/L以下的弱反应性结果患者血清标本34例,采用双份复检、中和确定试验以及一周内二次随访检测,并结合HBV其他标志物和病史资料等,对上述弱反应性HBsAg结果进行确认。结果34例患者血清标本首次检测HBsAg水平(S/H)为2.12~8.07,平均值为4.28,大部分同时存在抗-HBc阳性(占94.1%)。34例标本经双份复检HBsAg全部阳性。中和试验阳性31例(91.2%),阴性3例(8.80%)。2次随访,HBsAg均阳性30例(88.2%),2次均阴性4例(11.8%),未发现HBsAg以外的其他标志物改变。中和试验和随访结果均阳性为28例(82.4%),可确认HBsAg阳性;均阴性1例(2.94%),可确认HBsAg假阳性。另5例中和试验和随访结果不符,进一步随访。结论检测HBsAg弱反应结果大部分可确认HBsAg阳性,假阳性少见。上述几类确认方法对于明确诊断有一定价值。

Objective To discuss the role of three different methods in confirming the weakreactive results of HBsAg in serum. Methods 34 serum samples of hospitalized patients with HBsAg weak reactive(concentrations lower than 0.5 μg/L) on initial test by AxSYM were reconfirmed by three different methods as duplicate test,neutralizing confirmatory test and two times followup within one week. Results The mean HBsAg(S/N)of these serum samples was 4.28(range from 2.12 to 8.07).Most of them(94.1%) were AntiHBc positive too.All these 34 cases were positive in duplicate test.31(91.2%) were positive and 3(8.80%)negative in neutralizing confirmatory test.30(88.2%) were positive and 4(11.8%)negative in two times followup test.The other HBV markers except HBsAg detected positive in initial test of these samples were not finded at followup test in two times Both neutralizing confirmatory test and two times followup test positive 28(82.4%)samples were confirmed as HBsAg positive,while 1(2.94%)negative for the above two tests was confirmed as HBsAg negative.The other 5 cases should be investigated further because the results of neutralizing confirmatory test did not agree with two times followup test. Conclusion Most HBsAg weakreactive positive results by AxSYM can be confirmed as true positive with these three different methods.These methods are helpful in clinical diagnosis.