摘要:
目的:通过比较献血人群中谷丙转氨酶、乙肝表面抗原和前S1抗原检测与HBV-DNA检测结果的一致性,探讨前S1抗原检测在献血人群中筛查乙肝病毒感染者的应用价值.方法:1080份献血样本中,采用ELISA法检测前S1抗原,PCR法检测HBV-DNA,分析前S1抗原检测与HBV-DNA检测的一致性.结果:①1000例合格的献血人群中,前S1抗原的阳性率为0.3%,HBV-DNA阳性率为0.1%,两者呈中度一致性(Kappa值=0.499),且有统计学意义(P<0.05).②1080例样本中,ALT、HBsAg、前S1抗原的阳性率分别为5.83%、1.76%、1.67%,HBV-DNA阳性率为0.93%,ALT检测法与HBV-DNA检测无一致性(Kappa值=-0.0162);Hb sAg检测与HBV-DNA检测呈高度一致性(Kappa值=0.6160),前S1抗原检测与HBV-DNA检测呈高度一致性(Kappa值=0.7108),二者均有统计学意义(P<0.05).⑤ALT和HBsAg两项联合检测及ALT、HBsAg和前S1抗原三项联合检测的阳性率分剐为7.41%、7.69%,HBV-DNA阳性率为0.93%.两项联合检测法与HBV-DNA检验结果一致(Kappa值=0.1866),三项联合检测法与HBV-DNA检验结果一致(Kappa值=0.2019),均有统计学意义(P<0.05).结论:前S1抗原检测与HBV-DNA检测有较高一致性,能够减少献血人群中HBV感染的漏检;将ALT、HBsAg和前S1抗原进行联合检测能够提高HBV感染筛查率.%Objective:To investigate the value of determining Pre-S1 antigen in screening blood donators with HBV infection by comparing the consistency between ALT,HBsAg,Pre-S1 antigen tests and HBV-DNA tests for blood donators.Methods:A total of 1080 samples were respectively tested by Pre-S1 antigen with an ELISA method and HBV-DNA with a PCR method.Based on the results of tests,the consistency between Pre-S1 antigen and HBV-DNA tests was analyzed.Results:①In 1000 cases of qualified samples,the positive rate of Pre-S1 antigen was 0.3%,and the positive rate of HBV-DNA was 0.1%,these two test indexes had a medium-degree consistency (Kappa value 0.499)(P<0.05).②In 1080 cases of blood samples,the positive rates ofALT,HBsAg and Pre-S1 antigen were 5.83%,1.76% and 1.67%,and the positive rate of HBV-DNA was 0.93%.There was no statistical difference in the positive rate of HBsAg and Pre-S1 antigen but ALT respectively compared that of HBV-DNA (P>0.05).There were statistical difference for the positive rate of ALT,HBsAg and Pre-S1 antigen respectively compared that of HBV-DNA (P< 0.05).Kappa's test showed no consistency between ALT and HBV-DNA (Kappa value-0.0162),high-degree consistency between HBsAg and HBV-DNA (Kappa value 0.6160) and high-degree consistency between Pre-S1 antigen and HBV-DNA (Kappa value 0.7108) were found (P<0.05).③In 1080 cases of blood samples,the positive rate of combined ALT and HBsAg was 7.41%,the positive rate of combined ALT plus HBsAg plus Pre-S1 antigen was 7.69%,and the positive rate of HBV-DNA was 0.93%.There were statistical difference in the positive rates of the combined with Pre-S1 antigen and without Pre-S1 antigen respectively compared that of HBV-DNA (P<0.05).Kappa's test showed consistency between combined ALT plus HBsAg and HBV-DNA with a Kappa value of 0.1866,as well as a consistency between combined ALT plus HBsAg plus Pre-S 1 antigen and HBV-DNA with a Kappa value of 0.2019 (P<0.05).Conclusions:The test of Pre-S 1 antigen had a superior consistency with test of HBV-DNA,and could be used to screen the untested donated blood samples with HBV.Furthermore,a combined test of Pre-S1 antigen,ALT and HBsAg could increase the screening rates of donated blood samples with HBV.