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目的研究抗HBs在乙肝病毒(hepatitis B virus,HBV)既往感染中的临床价值。方法化学发光微粒子免疫测定法(chemiluminecence micro-particle immunoassay,CMIA)定量检测HBV既往感染者抗-HBs、抗-HBe、抗-HBc,抗HBs检测结果分为抗HBs阴性(<10 m IU/ml)、低水平(10~100 m IU/ml)、正常水平(100~1 000 m IU/ml)、高水平(≥1 000 m IU/ml),所有样本以抗-HBe结果分为抗HBe阳性组和抗HBe阴性组。结果抗HBs阳性组的抗HBc中位值(Median)低于抗HBs阴性组抗HBc中位值(8.03 vs.8.91),差异有统计学意义(Z=-3.305,P=0.001);抗HBs阳性组的抗HBe中位值低于抗HBs阴性组抗HBe中位值(0.32 vs.0.58),差异有统计学意义(Z=-2.46,P=0.014);在抗HBs阴性组、低水平组、正常水平组、高水平样本中抗HBe阳性率分别为55.26%、65.22%、79.04%、93.62%,经两两比较,低水平组和阴性组的抗HBe阳性率差异无统计学意义(P>0.05),而低水平组和正常水平组之间、正常水平组和高水平组之间差异有统计学意义(P<0.05);抗HBs阴性、低水平、正常水平、高水平样本在抗HBe阳性组中的构成比依次为17.14%、24.49%、40.74%、17.96%,在抗HBe阴性组的构成比依次为36.17%、34.04%、26.60%、3.19%,两组中抗HBs各水平的分布差异有统计学意义。结论抗HBs检测在HBV既往感染中具有重要临床价值,相比抗HBs阴性的HBV既往感染者,在抗HBs阳性的HBV既往感染者中,其抗HBc水平和抗HBe总体上较低,当抗HBs呈高应答时绝大多数抗HBe呈阳性,当抗HBe阴性时绝大多数不会呈抗HBs高应答状态。
Objective To study the clinical value of anti-HBs in the past infection of hepatitis B virus (HBV). Methods Chemiluminescence micro-particle immunoassay (CMIA) was used to detect anti-HBs, anti-HBe and anti-HBs in patients with previous HBV infection. The results of anti-HBs were negative for HBsAg (<10 m IU / ), Low level (10-100 mIU / ml), normal level (100-1000 mIU / ml) and high level (≥1 000 mIU / ml). All samples were divided into anti-HBe Positive group and anti-HBe negative group. Results Median of anti-HBs positive group was lower than that of anti-HBs negative group (8.03 vs.8.91), the difference was statistically significant (Z = -3.305, P = 0.001) The median of anti-HBe in positive group was lower than that in anti-HBs negative group (0.32 vs.0.58) (Z = -2.46, P = 0.014) The positive rates of anti-HBe in the normal group, the normal group and the high-level sample were 55.26%, 65.22%, 79.04%, 93.62% respectively. There was no significant difference in anti-HBe positive rates between the low and the negative groups P> 0.05). However, the difference between the normal group and the normal group was statistically significant (P <0.05). The anti-HBs negative, low level, normal level and high level were The proportions of anti-HBe positive groups were 17.14%, 24.49%, 40.74% and 17.96%, respectively, and the proportions of anti-HBe negative group were 36.17%, 34.04%, 26.60% and 3.19% The differences in the distribution of the levels were statistically significant. Conclusion The anti-HBs test has important clinical value in the previous infection of HBV. Compared with the previous anti-HBs-negative patients with HBV infection, the anti-HBc level and the anti-HBe in the former anti-HBs-infected patients were generally lower, The vast majority of anti-HBe positive HBs was highly responsive, most of the anti-HBs negative anti-HBs high status when anti-HBe negative.