丙型肝炎病毒核酸和抗体检测方法在人群筛查中的比较及应用

摘要

目的：探讨丙型肝炎病毒核酸和抗体检测方法在人群筛查中的应用。方法采用胶体金快速试验法和酶联免疫吸附试验（ELISA）检测丙型肝炎病毒（HCV）抗体，实时荧光定量 PCR（RT-PCR）检测 HCV-RNA 病毒载量。结果（1）539份样本中，其中266例抗体阴性，263例抗体阳性。（2）在67例 HCV-RNA 病毒载量小于103 IU/mL 组中，ELISA 法检测 HCV 抗体阳性有60例，胶体金快速试验法检测抗体阳性有30例。208例 HCV-RNA 病毒载量大于或等于103 IU/mL 组中，ELISA 法检测的抗体阳性有199例，胶体金快速法检测阳性的有181例，另外有6例两种抗体检测均为阴性患者 RNA 病毒载量大于或等于103 IU/mL。（3）对208例 HCV-RNA 病毒载量大于或等于103 IU/mL 样本分成4个组。GGT、ALT 及 AST 在4组间差异均有统计学意义（P ＜0．05），而 ALB 及 S/CO 值在4组间差异无统计学意义（P ＞0．05）。结论在人群筛查中为了减少漏诊率，尽早诊断丙型肝炎，要联合运用以上各实验室检测方法，综合分析。%Objective To investigate the application of hepatitis C virus RNA and antibody detection method in population screening.Methods The colloidal gold rapid test method and the enzyme-linked immunosorbent assay (ELISA)were adopted to detect hepatitis C virus (HCV)antibodies,and the real-time quantitative PCR (RT-PCR)was adopted to detect HCV-RNA viral load.Results (1)Among 539 samples,266 cases were antibody negative and 263 cases were antibody positive.(2)Among 67 cases in the HCV-RNA viral load <103 IU/mL group,60 cases were HCV antibody positive by ELISA and 30 cases were HCV antibody positive by colloidal gold rapid test.Among 208 cases in the HCV-RNA viral load ≥ 103 IU/mL,199 cases were antibody positive by ELISA,but only 181cases were antibody positive by the colloidal gold rapid method.Other 6 cases of were 2 kinds of antibody negative had the HCV-RNA viral load ≥ 103 IU/mL.(3)208 cases of HCV-RNA viral load ≥ 103 IU/mL sample were divided in-to four groups.GGT,ALT and AST were statistically significantly different P <0.05),while ALB and S/CO values hadno statisti-cal difference (P >0.05).Conclusion In order to reduce the missed diagnosis rate and diagnose hepatitis C as early as possible,the above laboratory detection methods should be jointly applied and the comprehensive analysis should be conducted in population screening.