摘要
目的分析乙型肝炎患者HBsAg转阴的临床意义及检测方法。方法将147例在邵阳市疾控中心就诊的HBsAg转阴患者的发展趋势及预后进行分析。HBsAg用ELISA法和胶体金法检测,同时检测HBV-DNA和ALT,对结果加以相关性分析。结果 88例用抗病毒药转阴的患者,ALT>200 U的转阴率47.5%,80 U<ALT<200 U的转阴率3.22%。ALT<80 U的转阴率0.0%。这三组之间的转阴率差异有统计学意义(P<0.05)。59例自然转阴的患者,ALT正常的占42.4%,40 U<ALT<80 U的占15.2%,ALT>80 U的占3.4%,终末期肝病占39.0%。四种结果差异有统计学意义(P<0.05)。ELISA法和胶体金法检测HBsAg阴性率分别为9.33%和28.00%,两种检测方法的阴性率差异有统计学意义(P<0.05)。结论胶体金法在患者治疗过程中的检测易出现假阴性;PCR法和ELISA法联合检测可以避免误诊;HBsAg转阴在有些情况下不能看成是痊愈的标志,要根据病情个体化分析。
Objective To analyze the clinical significance and detection methods of HBsAg negative returning in patients with hepatitis B.Methods The development trends and prognoses of 147 patients with HBsAg negative returning treated by Shaoyang Municipal CDC were analyzed.HBsAg was detected by ELISA and colloidal gold method,HBV-DNA and ALT were simultaneously determined,and correlation analysis was made on the results.Results Among 88 HBsAg negative returning patients with antiviral treatment,the negative conversion rates in patients with ALT200U,80UALT200U,and ALT80U were 47.5%,3.22%,and 0.0%,respectively.There were statistically significant differences in the negative conversion rate among the three groups（P0.05）.Among 59 patients with spontaneous HBsAg negative seroconversion,patients with normal ALT,40UALT80U,ALT80U,and the end-stage liver disease accounted for 42.4%,15.2%,3.4%,and 39.0%,respectively,and there were statistically significant differences among the results（P0.05）.HBsAg negative rates which detected by ELISA and colloidal gold method were 9.33% and 28.00%,respectively.There were statistically significant differences in the negative rate between the two test methods（P0.05）.Conclusions False negative results are likely to occur in patients detected by colloidal gold method in the course of treatment.Joint detection of the PCR and ELISA method can avoid misdiagnosis.HBsAg negative returning can not be seen as the cured marker in some cases,and it depends on individual analysis of the disease condition.
出处
《实用预防医学》
CAS
2013年第3期356-358,共3页
Practical Preventive Medicine
