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目的了解自然人群乙型肝炎病毒(HBV)感染现况及其不同检测指标的应用价值,为临床诊治提供参考依据。方法选取2008年1月-2009年12月医院住院、门诊及健康体检者共38 538人,应用Abbott i2000SR及配套试剂,对38 538份血样进行HBV血清学的定量检测;应用ROCHE LightCycler扩增仪对随机血样进行HBV-DNA检测。结果健康人群中HBsAg阳性371人,阳性率8.94%;HBsAg阴性的健康人群中HBcAb阳性1 215人,阳性率32.17%;HBcAb检测、HBsAg检测与HBV-DNA检测的一致性比较,其Kappa值分别为0.554、0.307,且HBcAb检测优于HBsAg检测(Z=9.17;P<0.01)。结论 HBV感染筛查指标中,HBcAb检测指标优于HBsAg的检测,HBsAg联合检测HBcAb指标更科学合理,可提高临床安全性,特别是临床用血、血液透析、各种侵入性诊疗及器官移植的安全性,降低HBV传播风险。
Objective To understand the status of hepatitis B virus (HBV) infection in the natural population and the value of different detection indexes to provide a reference for clinical diagnosis and treatment. Methods A total of 38 538 hospitalized, outpatient and healthy volunteers were selected from January 2008 to December 2009 in our hospital. Abbott i2000SR and matched reagents were used to detect the HBV serology in 38 538 blood samples. The ROCHE LightCycler Randomized blood samples were tested for HBV-DNA. Results The positive rate of HBsAg in healthy population was 371, and the positive rate was 8.94%. The positive rate of HBcAb in positive HBsAg-negative healthy population was 1 215, with a positive rate of 32.17%. The Kappa values of HBcAb, HBsAg and HBV-DNA were respectively 0.554,0.307, and HBcAb test better than HBsAg test (Z = 9.17; P <0.01). Conclusions HBcAb is better than HBsAg in detecting HBV infection, and HBsAb in combination with HBcAb is more scientific and reasonable, which can improve clinical safety, especially clinical blood, hemodialysis, various invasive medical procedures and organ transplantation Safety, reduce the risk of HBV transmission.