摘要
目的探讨丙型肝炎病毒核心抗原(hepatitis C virus core antigen,HCV-cAg)与核心抗体(HCV-Ab)联合检测在丙型肝炎诊断中的临床意义。方法回顾性分析2016-07/2019-07月在作者医院住院的115089例患者HCV-cAg、HCV-Ab检测结果,探讨HCV-cAg、HCV-Ab及HCV-RNA与丙型肝炎患者肝功能检测指标的相关性。结果HCV-cAg检测的阳性检出率为30.71%,阳性预测值为93.36%;HCV-Ab检测的阳性检出率为96.94%,阳性预测值为87.75%。经比较,HCV-cAg检测方案的阳性检出率显著低于HCV-Ab检测方案(χ^(2)=652.610,P=0.000),但阳性预测值却明显高于后者(χ^(2)=5.626,P=0.018)。Pearson相关性分析结果表明,HCV-cAg与总蛋白(total protein,TP)及球蛋白(globulin,GLB)均呈正相关(r/P分别为0.278/0.000,0.251/0.001);HCV-Ab与肝功能各检测指标间均未呈现显著相关性(P>0.05);HCV-RNA与丙氨酸氨基转移酶(alanine aminotrans,ALT)呈现正相关(r=0.431,P=0.005)。结论HCV-Ab与HCV-cAg联合检测丙型肝炎的临床诊断意义重大,不仅能够保持较高的阳性检出率,还有助于提高筛检试验的阳性预测值,显著降低HCV早期感染患者的漏检率,有利于及时有效控制HCV的传播。
Objective To explore the clinical significance of combined detection of hepatitis C virus core antigen(HCV-cAg)and HCV-Ab.Methods The results of HCV-cAg and HCV-Ab of 115089 patients who were hospitalized in author′s hospital from July 2016 to July 2019 were retrospectively analyzed.The correlations between HCV-cAg,HCV-Ab and HCV-RNA and liver function of hepatitis C patients were discussed.Results The positive detection rate of HCV-cAg was 30.71%,and the positive predictive value was 93.36%.The positive detection rate of HCV-Ab was 96.94%,while the positive predictive value was 87.75%.The positive detection rate of HCV-cAg was significantly lower than that of HCV-Ab(χ^(2)=652.610,P=0.000),but the positive predictive value was significantly higher than that of HCV-Ab(χ^(2)=5.626,P=0.018).Pearson correlation analysis showed that HCV-cAg was positively correlated with total protein(TP)and globulin(GLB)(r=0.278,P=0.000;r=0.251,P=0.001).HCV-Ab was not significantly correlated with liver function indicators(P>0.05),HCV-RNA was positively correlated with alanine aminotrans(ALT)(r=0.431,P=0.005).Conclusion The combined application of HCV-Ab and HCV-cAg in the clinical diagnosis of hepatitis C is of great significance.It can not only maintain a high positive detection rate,but also help to improve the positive predictive value of screening test,and it can significantly reduce the omission factor of patients with early HCV infection,and help to control the spread of HCV in time and effectively.
作者
寇国梅
郑山根
丁尹娟
刘万兵
倪文旭
张艳红
刘磊
KOU Guomei;ZHENG Shan′gen;DING Yinjuan;LIU Wanbing;NI Wenxu;ZHANG Yanhong;LIU Lei(Department of Transfusion,General Hospital of Central Theater Command,Wuhan Hubei 430070,China)
出处
《华南国防医学杂志》
CAS
2020年第9期619-621,共3页
Military Medical Journal of South China
基金
湖北省卫生健康委科研联合项目(WJ2018H0070,WJ2019H092)
湖北省自然科学基金项目(2018CFB184)。
