经ELISA法检测呈单独乙肝病毒核心抗体的可靠性

摘要

Objective To research the reliability of isolated anti‐HBc tested by Enzyme‐Linked Immunosor‐bent Assay (ELISA ) .Methods 178 samples with isolated anti‐HBc initially tested by ELISA were retested by CMIA on Architect i2000 analyzer .Results Among the 29 samples with initial positive anti‐HBe ,the true positive rates of anti‐HBs and anti‐HBe were 100 % (29/29) and 90% (26/29) ,respectively .Among the 149 samples with ini‐tial negative anti‐HBe ,15 .44% (23/149) anti‐HBs was retested positive ;then 28 .19% (42/149)anti‐HBe was retest‐ed positive among the 126 negative‐anti‐HBs samples ,and 55 .03% (82/149) anti‐HBc was retested positive among the 84 negative anti‐HBe samples .In total ,the false positive rate of anti‐HBc was 1 .34% (2/149) .Conclusion False positive anti‐HBc ,False negative anti‐HBe and anti‐HBs could be confirmed among the isolated anti‐HBc initially tested by ELISA ,which cause high missed diagnosis of past HBV infection with immunity and HBV vaccination and therefore retesting anti‐HBs ,anti‐HBe and anti‐HBc in CMIA could be suggested .Initial positive anti‐HBe tested by ELISA had good confirmatory value for isolated anti‐HBc .%目的研究酶联免疫吸附法（ELISA）检测乙型肝炎免疫学标志物（HBV‐M ）呈单独抗‐HBc 阳性的可靠性。方法收集西安交通大学医学院第二附属医院近期 HBV‐M 检测呈单独抗‐HBc 样本178例，其中抗‐HBe阳性样本29例；以 CMIA 法为参考方法，复检抗 HBs ，抗 HBe ，抗 HBc 。结果29例抗‐HBe 阳性的单独抗‐HBc 样本中，抗‐HBc 真阳性率100％，抗‐HBe 真阳性率90％（26／29）；149例抗‐HBe 阴性的单独抗‐HBc 样本中，依次检出抗‐HBs 阳性率15．44％（23／149），抗‐HBe 阳性率为28．19％（42／149），抗‐HBc 阳性率为55．03％（82／149），抗‐HBc 的假阳性率为1．34％（2／149）。结论 ELISA 检测 HBV‐M 结果呈单独抗‐HBc 时存在假阳性，同时由于抗‐HBs 和抗‐HBe 存在假阴性，造成部分产生免疫保护能力的 HBV 既往感染者和 HBV 疫苗接种者被误诊，ELISA法同步检测抗‐HBe 阳性结果对单独抗‐HBc 样本具有良好的确证价值。