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目的:探讨酶联免疫吸附法(ELISA)检测丁型肝炎病毒抗体Ig M(抗-HD Ig M)与乙肝表面抗原(HBs Ag)之间的相关性。方法:检测某三甲医院4 428例门诊和住院患者抗-HD Ig M;经阻断试验和巯基乙醇破坏试验后确认抗-HD Ig M真假阳性;真阳性样品同时用ELISA和电化学发光法(ELC)检测HBs Ag;假阳性样品进行类风湿因子(RF)的检测。结果:经ELISA检测有155例抗-HD Ig M阳性样品,确认有118例是真阳性、37例假阳性。118例抗-HD Ig M真阳性样品用ELISA和ELC法检测HBs Ag都有超过50%是阴性;37例抗-HD Ig M假阳性样品有28例RF阳性。结论:抗-HD Ig M阳性同时HBs Ag阴性主要可能是HBV隐匿性感染;HDV急性感染时HBs Ag大量消耗、浓度太低、难以检测等原因。
Objective: To investigate the correlation between hepatitis B virus antigen IgM (anti-HD Ig M) and hepatitis B surface antigen (HBs Ag) by enzyme linked immunosorbent assay (ELISA). Methods: 4 428 outpatients and inpatients with anti-HD Ig M in a top-three hospital were tested for true-false positive anti-HD Ig M after blocking test and mercaptoethanol destruction test. The positive samples were detected by ELISA and electrochemiluminescence (ELC) detection of HBsAg; false positive samples for the detection of rheumatoid factor (RF). RESULTS: A total of 155 anti-HD Ig M positive samples were detected by ELISA, 118 of which were true positives and 37 false-positives. 118 cases of anti-HD Ig M true positive samples detected by ELISA and ELC HBsAg more than 50% were negative; 37 anti-HD Ig M false positive samples of 28 cases of RF-positive. Conclusion: The anti-HD Ig M positive and negative HBsAg may be occult HBV infection; HDV acute infection HBsAg consumption in large quantities, the concentration is too low, difficult to detect and other reasons.