血清HBcrAg、线性化HBsAg对隐匿性乙型肝炎的诊断价值

发布时间：2018-04-25 20:39

  本文选题：隐匿性乙型肝炎 + 乙肝病毒核心相关抗原　； 参考：《山东医药》2017年08期

【摘要】：目的探讨血清乙肝病毒核心相关抗原(HBcr Ag)及线性化乙型肝炎病毒表面抗原(HBs Ag)对隐匿性乙型肝炎(OBI)的诊断价值。方法选择OBI患者63例(OBI组)、体检健康者150例(对照组),采用化学发光酶联免疫分析法检测两组血清HBcr Ag、线性化HBs Ag,采用荧光定量PCR法检测血清HBV DNA。采用受试者工作特征(ROC)曲线分析HBcr Ag、线性化HBs Ag二者单独及联合检测对OBI的诊断效能。结果 OBI组和对照组血清HBcr Ag阳性率分别为90.5%和10.7%,线性化HBs Ag阳性率分别为42.9%和6.0%,两组比较差异均有统计学意义( χ~2分别为125.5、42.9,P均0.05)。相关分析显示,HBV DNA与HBcr Ag、HBV DNA、线性化HBs Ag均呈正相关(R2分别为0.471 4、0.122 2、0.086 8,P0.05或0.01)。ROC曲线分析显示,血清HBcr Ag、线性化HBs Ag诊断OBI的曲线下面积(AUC)分别为0.911(95%CI为0.864~0.946)、0.683(95%CI为0.616~0.745),二者联合检测诊断OBI的AUC为0.895(95%CI为0.846~0.933),血清HBcr Ag对OBI的诊断效能显著优于线性化HBs Ag(Z=6.134,P0.05),二者联合检测并不能提高其对OBI的诊断效能(Z=0.657,P0.05)。当血清HBcr Ag、线性化HBs Ag的最佳临界值分别为100 U/m L、0.48 IU/m L时,血清HBcr Ag诊断OBI的敏感性显著高于线性化HBs Ag( χ~2=121.4,P0.05),特异性稍低于线性化HBs Ag( χ~2=3.034,P0.05),二者联合检测诊断OBI的敏感性和特异性较单独检测HBcr Ag并未明显提高( χ~2分别为1.322、3.802,P均0.05)。结论血清HBcr Ag与HBV DNA存在良好的相关性,对OBI的诊断效能优于线性化HBs Ag,但联合检测HBcr Ag、线性化HBs Ag并不能提高其诊断效能;血清HBcr Ag可单独作为诊断OBI的血清学指标。
[Abstract]:Objective to investigate the diagnostic value of serum HBcr Ag and linear HBV surface antigen (HBs Ag) in the diagnosis of occult hepatitis B virus (OBI). Methods 63 patients with OBI and 150 healthy controls (control group) were selected. The serum HBcr Ags and linearized HBs Agwere detected by chemiluminescence enzyme-linked immunosorbent assay (CLIA), and serum HBV DNA was detected by fluorescence quantitative PCR assay. The diagnostic efficacy of HBcr Ag and linearized HBs Ag in OBI was analyzed by using the operating characteristic curve. Results the positive rates of serum HBcr Ag in OBI group and control group were 90.5% and 10.7%, respectively, and the positive rates of linearized HBs Ag were 42.9% and 6.0, respectively. The difference between the two groups was statistically significant (蠂 ~ 2 = 125.5, P < 0.05). Correlation analysis showed that there was a positive correlation between HBV DNA and HBcr HBs DNA, and the linear HBs Ag had positive correlation (R2 = 0.471 40.122 2 / 0.0868) or 0.01).ROC curve analysis. Serum HBcr Ag, the area under the curve of linearized HBs Ag for the diagnosis of OBI were 0.864 卤0.946 and 0.683 / 95 CI, respectively, respectively. The AUC of the two combined detection of OBI was 0.846 ~ 0.933. The diagnostic efficacy of serum HBcr Ag for OBI was significantly better than that of linearized HBs AgZ6.134 (P0.05). It can improve the diagnostic efficiency of OBI. When the optimal critical value of serum HBcr Ag, linearized HBs Ag is 0.48 IU/m / L, respectively, The sensitivity of serum HBcr Ag in the diagnosis of OBI was significantly higher than that in linearized HBs (蠂 ~ (2) 2121.4) (P 0.05), and the specificity was slightly lower than that in linear HBs (蠂 ~ (2 +) (蠂 ~ (2 +). The sensitivity and specificity of the combined detection of OBI and HBcr Ag were not significantly higher than that of HBcr Ag (蠂 ~ 2 = 1.3223.802, P < 0.05, respectively). Conclusion there is a good correlation between serum HBcr Ag and HBV DNA, and the diagnostic efficacy of serum HBcr Ag is better than that of linearized HBs Ag.However, the combined detection of HBcr Ag and linearized HBs Ag can not improve the diagnostic efficacy, and serum HBcr Ag can be used as a serological index for the diagnosis of OBI.
【作者单位】： 佛山市第一人民医院;首都医科大学附属北京天坛医院;
【基金】：广东省医学科研基金立项项目(B2015127)
【分类号】：R512.62
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本文编号：1802876