本文選題：隱匿性乙型肝炎 + 乙肝病毒核心相關(guān)抗原��； 參考：《山東醫(yī)藥》2017年08期

【摘要】：目的探討血清乙肝病毒核心相關(guān)抗原(HBcr Ag)及線性化乙型肝炎病毒表面抗原(HBs Ag)對(duì)隱匿性乙型肝炎(OBI)的診斷價(jià)值。方法選擇OBI患者63例(OBI組)、體檢健康者150例(對(duì)照組),采用化學(xué)發(fā)光酶聯(lián)免疫分析法檢測(cè)兩組血清HBcr Ag、線性化HBs Ag,采用熒光定量PCR法檢測(cè)血清HBV DNA。采用受試者工作特征(ROC)曲線分析HBcr Ag、線性化HBs Ag二者單獨(dú)及聯(lián)合檢測(cè)對(duì)OBI的診斷效能。結(jié)果 OBI組和對(duì)照組血清HBcr Ag陽性率分別為90.5%和10.7%,線性化HBs Ag陽性率分別為42.9%和6.0%,兩組比較差異均有統(tǒng)計(jì)學(xué)意義( χ~2分別為125.5、42.9,P均0.05)。相關(guān)分析顯示,HBV DNA與HBcr Ag、HBV DNA、線性化HBs Ag均呈正相關(guān)(R2分別為0.471 4、0.122 2、0.086 8,P0.05或0.01)。ROC曲線分析顯示,血清HBcr Ag、線性化HBs Ag診斷OBI的曲線下面積(AUC)分別為0.911(95%CI為0.864~0.946)、0.683(95%CI為0.616~0.745),二者聯(lián)合檢測(cè)診斷OBI的AUC為0.895(95%CI為0.846~0.933),血清HBcr Ag對(duì)OBI的診斷效能顯著優(yōu)于線性化HBs Ag(Z=6.134,P0.05),二者聯(lián)合檢測(cè)并不能提高其對(duì)OBI的診斷效能(Z=0.657,P0.05)。當(dāng)血清HBcr Ag、線性化HBs Ag的最佳臨界值分別為100 U/m L、0.48 IU/m L時(shí),血清HBcr Ag診斷OBI的敏感性顯著高于線性化HBs Ag( χ~2=121.4,P0.05),特異性稍低于線性化HBs Ag( χ~2=3.034,P0.05),二者聯(lián)合檢測(cè)診斷OBI的敏感性和特異性較單獨(dú)檢測(cè)HBcr Ag并未明顯提高( χ~2分別為1.322、3.802,P均0.05)。結(jié)論血清HBcr Ag與HBV DNA存在良好的相關(guān)性,對(duì)OBI的診斷效能優(yōu)于線性化HBs Ag,但聯(lián)合檢測(cè)HBcr Ag、線性化HBs Ag并不能提高其診斷效能;血清HBcr Ag可單獨(dú)作為診斷OBI的血清學(xué)指標(biāo)。
[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 鹵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.
【作者單位】： 佛山市第一人民醫(yī)院;首都醫(yī)科大學(xué)附屬北京天壇醫(yī)院;
【基金】：廣東省醫(yī)學(xué)科研基金立項(xiàng)項(xiàng)目(B2015127)
【分類號(hào)】：R512.62
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本文編號(hào)：1802876