摘要
我们采用具有世界卫生组织( WHO) 溯源性的标准血清建立浓度标准曲线, 评估微粒子酶免疫分析法(MEIA) 和酶联免疫吸附试验( ELISA) 的检测灵敏度, 并对97 例经确认为低水平乙型肝炎表面抗原( HBsAg)的阳性结果进行检测和比对分析; 同时综合评估低水平HBsAg 患者的临床各项指标, 探究低水平HBsAg 检测的临床意义。根据MEIA、ELISA 的S/CO 值分析, 2 种方法的检测灵敏度分别为0. 095 IU/ml 和0. 378 IU/ml;ELISA 对97 例低水平HBsAg 的检出率仅为45. 4% ( 44 /97) ; 在97 例低水平HBsAg 患者中, HBV DNA≥1 ×103 拷贝/ml 占17. 5% ( 17/97) , 肝功能异常率占38. 1% ( 37 /97) , 其中明确诊断为乙型肝炎相关疾病的19 例患者中, 肝硬化占57. 9% ( 11 /19) 。因此灵敏度高、特异性好的方法有助于低水平HBsAg 的检出, 有利于对这些人群的诊断和治疗。部分低水平HBsAg 患者往往伴随病毒复制及肝功能的慢性损伤, 预后不良, 应引起临床的高度重视和关注。
Abstract
In order to evaluate the sensitivity of microparticle enzyme immunoassay ( MEIA) and enzyme-linked immunosorbent assay ( ELISA) , a standard concentration curve was established by measuring the HBsAg calibrator
with a standard serum from the World Health Organization ( WHO) . Ninety-seven serum samples with low level HBsAg were analyzed via these two methods and compared with the individual patient’s clinical characteristics in order to investigate the significance of low level HBsAg detection. According to the HBsAg concentration standard curve, the sensitivities of MEIA and ELISA were 0. 095 and 0. 378 IU/ml, espectively. Only 44 out of 97 patients tested positive when samples were analyzed by ELISA. Among the 97 samples, the rate of HBV DNA≥ 1 ×103 opies /ml and abnormal liver function tests were 17. 5% ( 17/97) and 38. 1% ( 37/97) , respectively. Eleven cases of liver cirrhosis were found among 19 patients who were previously diagnosed as positive HBV. These results suggest that low level HBsAg infection should be detected using highly sensitive and specific methods in order to diagnose and treat patients in a timely manner. Patients with low serumconcentrations of HBsAg may also display increased levels of HBV DNA replication and chronic liver damage. It is implicated that patients with potential HBV infection should
be monitored.
关键词
微粒子酶免疫分析法 /
酶联免疫吸附试验
Key words
Hepatitis B surface antigen /
Microparticle enzyme immunoassay /
Enzyme-linked immunosobnent assay
王 蕾；刘 华；王雯静；张勤弢；高 锋.
低水平乙型肝炎表面抗原的检测及其临床价值评估[J]. 微生物与感染. 2009, 4(1): 9-12
WANG Lei；LIU Hua；WANG Wen-jing；ZHANG Qin-tao；GAO Feng.
Detection of low level HBsAg and its clinical significance
[J].
Journal of Microbes and Infections. 2009, 4(1): 9-12
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