丁型肝炎病毒抗体IgM与乙肝表面抗原相关性探讨

摘要

目的:探讨酶联免疫吸附法(ELISA)检测丁型肝炎病毒抗体IgM(抗-HD IgM)与乙肝表面抗原(HBsAg)之间的相关性.方法:检测某三甲医院4428例门诊和住院患者抗-HD IgM;经阻断试验和巯基乙醇破坏试验后确认抗-HD IgM真假阳性;真阳性样品同时用ELISA和电化学发光法(ELC)检测HBsAg;假阳性样品进行类风湿因子(RF)的检测.结果:经ELISA检测有155例抗-HD IgM阳性样品,确认有118例是真阳性、37例假阳性.118例抗-HD IgM真阳性样品用ELISA和ELC法检测HBsAg都有超过50%是阴性;37例抗-HD IgM假阳性样品有28例RF阳性.结论:抗-HD IgM阳性同时HBsAg阴性主要可能是HBV隐匿性感染;HDV急性感染时HBsAg大量消耗、浓度太低、难以检测等原因.%Objective:To investigate the correlation between anti-hepatitis D IgM (anti-HD IgM ) determined by enzyme-linked immunosorbent assay (ELISA)and HBsAg. Methods:The anti-HD IgM in 4428 outpatients and inpatients hospitalized in a 3A-grade hospital were determined. The blocking test and 2-mercaptoethanol destructive experiment were used to confirm that the anti-HD IgM was true or false positive. The HBsAg in the true positive samples were determined by ELISA and electrochemiluminescence (ELC). The false positive samples were determined for rheumatoid factor (RF). Results:A total of 155 anti-HD IgM positive samples were determined by ELISA,and 118 true positive and 37 false positive were confirmed. Among the 118 true positive anti-HD IgM samples,more than 50% of the HBsAg was negative determined by ELISA and ELC;and 28 of the 37 false positive anti-HD IgM samples were RF positive. Conclusion:Anti-HD IgM positive and HBsAg-negative may be HBV occult infection. The HBsAg consumption is large,and its concentration is too low in HDV acute infection,which is difficult to detect.