CLIA法与ELISA法对检测血清HBeAb与HBcAb结果的分析

目的通过CLIA与ELISA对临床标本HBeAb与HBcAb的检测结果,探讨两种方法在临床应用及统计学中的意义。方法对2016年2月至2016年6月间来我院就诊患者共430例,采用CLIA法与ELISA法同时检测血清HBeAb和HBcAb,并对检测结果进行分析。结果当HBs Ag阴性时,CLIA法与ELISA法HBeAb阳性值之间差异性具有相关性(P<0.05),同时,CLIA法与ELISA法检测HBeAb与HBcAb阴性结果之间差异均具有相关性(P<0.05)。结论 CLIA法与ELISA法检测血清HBeAb与HBcAb结果有差异性,应用及流行病统计时应注意方法学的选择。

斑点金免疫渗滤法测定人全血中抗HBc抗体

目的：建立一种适合斑点金免疫渗滤法（Ｄｏｔ Ｉｍｍｕ ｎｏ ｇｏｌｄＦｉｌｔｒａｔｉｏｎＡｓｓａｙＤＩＧＦＡ）特点的快速全血诊断方法。方法：选择可瞬间分离血中细胞和血清的膜，依据ＤＩＧＦＡ的原理对３３份ＨＢｃＡｂ阳性血样和４８份阴性血样进行了全血抗ＨＢｃＡｇ抗体的检测。结果：测定阳性标本符合率为９６．７％，阴性标本符合率为１００％。结论：提供了一种简便、快速、可行的全血检测抗ＨＢｃＡｇ抗体的方法。

Helicobacter cinaedi bacteremia with cellulitis after ABO-incompatible living-donor liver transplantation: Case report

Helicobacter cinaedi(H. cinaedi), a Gram-negative spiral-shaped bacterium, is an enterohepatic nonHelicobacter pylori Helicobacter species. We report the first case of H. cinaedi bacteremia with cellulitis after liver transplantation. A 48-year-old male, who had been a dog breeder for 15 years, underwent ABO-incompatible living-donor liver transplantation for hepatitis C virus-induced decompensated cirrhosis using an anti-hepatitis B core antibody-positive graft. The patient was preoperatively administered rituximab and underwent plasma exchange twice to overcome blood type incompatibility. After discharge, he had been doing well with immunosuppression therapy comprising cyclosporine, mycophenolate mofetil, and steroid according to the ABO-incompatible protocol of our institution. However, 7 mo after transplantation, he was admitted to our hospital with a diagnosis of recurrent cellulitis on the left lower extremity, and H. cinaedi was detected by both blood culture and polymerase chain reaction analysis. Antibiotics improved his symptoms, and he was discharged at day 30 after admission. Clinicians should be more aware of H. cinaedi in immunocompromised patients, such as ABO-incompatible transplant recipients.

全自动微粒子酶免检测法与微粒子化学发光法的比较研究

目的比较雅培公司的AxSYM全自动微粒子酶免分析仪与i2000微粒子化学发光分析仪在检测患者标本HBc-Ab浓度中的应用。方法同时用两种仪器检测154例患者标本中的HBc-Ab浓度。结果 154例标本中有86例用两种仪器检测均为阴性,66例均为阳性。有2例标本AxSyM仪器测定为阳性,i2000微粒子化学发光分析仪测定为阴性。两种仪器测定结果阳性符合率为100%,阴性符合率为95%。结论全自动微粒子酶免检测法与微粒子化学发光法在检测HBc-Ab浓度方面一致性较好。

婴幼儿活体肝移植受者接受乙型肝炎核心抗体阳性供肝后的早期安全性分析

目的探讨婴幼儿活体肝移植受者接受乙肝核心抗体阳性(HBc Ab+)供肝后术后早期安全性分析。方法对天津市第一中心医院自2010年7月至2013年12月86例活体婴幼儿肝移植供受体的资料进行收集和登记,依据供肝HBc Ab检测结果分为HBc Ab+组32例和HBc Ab-组54例,对两组患儿术前状态、手术时间、重症监护病房(ICU)逗留时间、术后肝功能指标进行比较分析。结果 86例亲体肝移植受者死亡5例,总病死率为5.81%,HBc Ab+组和HBc Ab-组病死率分别为9.37%和3.70%,两组病死率比较差异无统计学意义。所有患儿在围术期均无新发乙肝出现;两组受者平均年龄、平均体重、术前PELD评分,两组供者平均年龄、平均体重、供肝重量,受者手术时间(分钟:547.44±71.93比546.76±95.67)、ICU逗留时间(小时:119.27±50.61比126.61±70.78)、术前1、2天及术后1、3、7、14、28天血清总胆红素(TBil)、直接胆红素(DBil)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、国际标准化比值(INR)比较差异均无统计学意义(均P>0.05)。结论在精准评估及采取适当措施预防乙肝复发的基础上,HBc Ab+供肝至少在围术期对患儿是安全的。

酶联免疫法检测乙肝核心抗体的精密度评价

目的探讨酶联免疫法检测乙肝核心抗体(HBc Ab)的精密度问题。方法依照CLSI EP5-A2文件,用稳定的高、低值实验样本对采用ELISA法检测的HBc Ab进行精密度实验,对其批内精密度(S批内)、批间精密度(S批间)、天间精密度(S天间)和总不精密度(CV_总)进行评价。结果本次研究HBc Ab测定的低值(L)精密度的CV_(批内)、CV_(天间)、CV_总分别为3.3%、5.0%、6.3%;HBc Ab测定高值(H)精密度的CV_(批内)、CV_(天间)、CV_总分别为3.1%、1.5%、4.1%。结论本实验室酶联免疫法检测的HBc Ab精密度CV_(批内)均低于1/4TEa(5%),CV_(天间)均低于1/3TEa(6.7%),CV_总均低于厂商声明值(20%),说明其总不精密度都在可接受范围,本次评价精密度良好,随机误差小,本实验室中所使用的方法和仪器均可以满足临床正常使用。应用EP5-A2文件评价的精密度实验操作简单,经济适用。

Viral Hepatitis B during Chronic Inflammatory Bowel Diseases at Fez University Hospital: Prevalence and Risk Factors

Patients with chronic inflammatory bowel diseases (IBD) have long been considered at risk for viral hepatitis B. However, recent epidemiological studies have found similar prevalence, or even lower than in the general population. The objective of this work is to determine the prevalence of viral hepatitis B (HVB) during IBD, to determine the risk factors in the service of Hepato-gastroenterology of university hospital Hassan II-Fez, and of evaluate the impact on therapeutic management. PATIENTS AND METHODS: This is a retrospective study, spread over a period of 17 years and a half (January 2001-June 2017). All patients treated for IBD who are tested for Hbs Ag and anti Hbcwere included. The HVB DNA levels were tested in case of positivity of HbsAgor anti Hbc. Results: Over the study period, 755 patients were included. The average age of our patients was 35 years [14 - 87] with a sex-ratio H/F of 0.67. We had 391 cases (51.8%) of Crohn’s disease (CD) and 364 cases (48.2%) of ulcerative colitis (UC). Anti HBctest was positive in 1.98% of cases (N = 15). In these patients, HBsAg was positive in 1.19% of cases (N = 9). The prevalence of HVB was 2.55% in CD (N = 10) versus 1.37% in UC (N = 5). In our work, no history of surgery, digestive endoscopy or transfusion has been shown to be a risk factor for viral transmission. CONCLUSION: The prevalence of HVB in IBD is similar to that of the general population. The safety of blood transfusions and the improvement of asepsis probably explain these results. However, the risk of viral reactivation during HVB, sometimes fatal under immunosuppressive treatment, requires systematic screening.

乙肝病毒标记物阳性表型血清标本HBV-DNA水平分析

目的分析乙肝病毒标记物阳性表型(Pres1、HBcAb-IgM、HBsAg、HBsAb、HBeAg、HBeAb、HBcAb-IgG中两项或两项以上阳性)血清标本中HBV-DNA水平,为乙型病毒性肝炎的诊断、病情发展及预后评估提供理论依据。方法对以ELISA法检测Pres1、HBcAb-IgM、HBsAg、HBsAb、HBeAg、HBeAb、HBcAb-IgG项目中两项或两项以上同时阳性的652例标本用荧光定量PCR法检测HBV-DNA水平,并对检测结果进行统计分析。结果非活动期标记物表型组可出现高水平HBV-DNA;正常对照组和非活动期标记物表型组血清HBV-DNA平均水平均明显低于活动期标记物表型组(P<0.01);高水平HBV-DNA标本中不一定会同时出现Pres1、HBeAg、HBcAb-IgM等活动期标记物。结论活动期乙肝病毒标记物检测阴性不能排除患者体内是否存在乙肝病毒复制,Pres1、HBeAg、HBcAb-IgM联合检测可以提高病毒感染阳性检出率,同时可以评估疾病的进展情况。