全自动化学发光分析仪及核酸扩增仪检测乙肝标志物的应用

摘要

目的：探讨全自动化学发光分析仪及核酸扩增仪检测乙肝标志物的临床应用。方法：选择2235例住院及门诊收治的肝功能异常病例，分别用化学发光方法检测乙肝病毒表面抗原(HBsAg)，用实时荧光聚合酶链式反应(FQ-PCR)方法检测乙肝病毒基因(HBV-DNA)含量，并对结果进行分析。每位患者检测HBsAg与HBV-DNA均采用同一份标本。结果：全部受检标本中，化学发光方法检测HBsAg阳性率为61.34%，显著高于FQ-PCR方法检测阳性率(48.59%)，差异有统计学意义(x2=73.41，P＜0.01)。将化学发光检测HBsAg的结果分成强阳性、弱阳性和阴性3组，不同组间FQ-PCR检测HBV-DNA的阳性率显著不同，差异有统计学意义(x2=1863.60，P＜0.01)，强阳性组HBV-DNA阳性率为97.31%，显著高于弱阳性组，差异有统计学意义(x2=966.90，P＜0.01)。结论：全自动化学发光分析仪所采用的化学发光方法对筛查乙肝病毒感染效果较好，而扩增仪所采用的FQ-PCR方法对检测乙肝病毒复制及疗效的监测效果更好，二者联合检测可提高乙肝患者的检出率并可对乙肝患者的病情及疗效作出准确判断。%Objective:To investigate the clinical applications of chemiluminescence immunoassay and real-time PCR in HBV markers.Methods: We select 2235 inpatients and outpatients of GI Medicine in our hospital from 2013 to 2014. Detect surface antigen of hepatitis B virus (HBsAg) and Hepatitis B virus gene (HBV-DNA) of every sample by chemiluminescence immunoassay and real-time fluorescent quantitative polymerase chain reaction(FQ-PCR), respectively. And analyze the results. The same specimen was used to detect the surface antigen of hepatitis B virus and HBV-DNA in each patient.Results: In 2235 case, the positive rate of chemiluminescence immunoassay detecting HBsAg was 61.34%, which was higher than the positive rate of FQ-PCR(48.59%,x2=73.41,P<0.01). Grouping the results of chemiluminescence immunoassay into strong positive, weak positive and negative. There were statistical difference (x2=1863.60,P<0.01) among the positive rate of FQ-PCR detecting HBV-DNA. The statistical difference(x2=966.90, P<0.01) of HBV-DNA’s positive rate was found between strong positive group (97.31%) and weak positive group (15.41%). Conclusion: It is better to screen HBV infected persons by chemiluminescence immunoassay, while it is better to detect the replication of hepatitis B virus and the efficacy by FQ-PCR. Combined utilization can improve the detection rate and make accurate judgments of the condition of patients and treatment effects.