摘要
目的 评价戊型肝炎 (戊肝 )抗体E2 IgM(抗 HEVE2 IgM)酶联免疫试剂 (捕获法 )在反映戊肝流行特征和对戊肝早期诊断中的作用。方法 在首发病例 2 6d后对某单位戊肝暴发人群和相邻单位对照人群进行血清抗 HEVE2 IgM、IgG检测 ;部分人群进行美国Genelabs抗 HEVIgM、IgG的平行检测。结果 抗 HEVE2 IgM试剂捕获法在对照人群中仅检出 1例阳性 (0 11% ) ,且阳性和阴性之间可明显区分 ,其特异度为 99 89% ;在暴发流行人群中检出 14 5例阳性 (8 6 6 % ) ,显著高于对照人群 (P <0 0 0 1) ;暴发人群中戊肝患者的血清学动态变化为 :抗 HEVE2 IgM在暴露时间为 30～ 6 0d时保持较高吸光度 (A值 ) ,随着时间的延长A值呈明显下降趋势 ;抗 HEVE2 IgM阳性在该组人群中与性别和年龄无关 ;在暴发人群抗 HEVE2 IgM(+)的 115例患者中 ,Genelabs抗 HEVIgG检测出 88份阳性 ,检出率为 76 5 2 % ,漏检 2 7例 ,漏检率为 2 3 4 8%。对照人群随机抽样 179例患者中有 2 0例Genelabs抗 HEVIgG(+) ,阳性率为 11 17%。在 110份抗 HEVE2 IgM(+)的血样中 ,Genelabs抗 HEVIgM只检测出 76份 ,检出率为 6 9 0 9% ;有 16例患者Genelabs抗 HEVIgG、IgM均未能检出 ;Genelabs抗 HEVIgG和IgM的不一致率为 2 5 4 5 %。结论 ?
Objective To compare the serological characters of an outbreak of hepatitis E and evaluate sensitivity and specificity of anti-HEV E2-IgM. Methods The sera collected from the employees of an outbreak unit were detected for anti-HEV E2-IgM and IgG, and the serum samples from a neighboring department were used as control. The results detected with anti-HEV E2-IgM、IgG and Genelab anti-HEV IgM、IgG in some samples were compared. Results The positive rate of anti-HEV E2-IgM in the control group was 0.11%.The results between the positive and the negative samples can be distinguished easily. The specificity of anti-HEV E2-IgM is about 99.89%. The positive rate of anti-HEV E2-IgM in outbreak striken population was 8.66%, significantly higher than that in the control group (P<0.001). The results from HEV patients’ serial samples in the outbreak unit showed that the anti-HEV E2-IgM titer was high 30-60 days after the infected and then declined clearly. The positivity seemed unrelated to neither sex nor age.Among the 115 positive to anti-HEV E2-IgM, 27 were negative to Genelab anti-HEV IgG, the fact indicated a rather high risk of misdiagnosis of about 23.48%. In the 179 randomized samples of the control group, the positive rate of Genelabs anti-HEV IgG was about 11.17%. In 110 samples for the positive anti-HEV E2-IgM, the positive ratio of Genelabs anti-HEV IgG was about 76.36%, and that of Genelabs anti-HEV IgM only 69.09%. There were 16 samples negative for both Genelabs anti-HEV IgG and IgM. The ratio of the difference between the Genelabs anti-HEV IgG and IgM was about 25.45%. Conclusion The specificity of anti-HEV E2-IgM was about 99%, and false positive rate was low. The sensitivity of anti-HEV E2-IgM in acute hepatitis E infection was 25%-30% higher than that of Genelabs anti-HEV IgM、IgG. The infected persons in the outbreak unit can be preferably distinguished from the non-infected persons by anti-HEV E2-IgM. Anti-HEV E2-IgM can image the characters of the outbreak of HEV and played a great role in the c
出处
《中华实验和临床病毒学杂志》
CAS
CSCD
北大核心
2005年第1期35-38,共4页
Chinese Journal of Experimental and Clinical Virology
关键词
抗-HEV
人群
戊肝
暴发
检出
阳性
患者
血清抗体
动态变化
感染诊断
Hepatitis E
Serology
Antibodies,viral
Immunoglobulin M
Immunoglobulin G
Enzyme-linked immunosorbent assay
