免疫人群乙肝抗体阳性率调查及乙肝核心抗体检测方法探讨

目的 调查我院检测人群乙型肝炎病毒表面抗体(HBsAb)及乙型肝炎病毒核心抗体(HBcAb)阳性率,并探讨检测方法选择及检测操作模式对免疫人群乙肝核心抗体结果的影响。方法 统计2012—2013年用化学发光微粒子免疫检测法(CMIA)和酶联免疫竞争抑制一步法(ELISA)检测乙肝人群的HBsAb及HBcAb阳性率,并按≤2岁、2~20岁、>20岁3个年龄分段比较;收集92例免疫人群样本用CMIA和3种ELISA法检测HBcAb;用同种ELISA法试剂,改变操作模式进行HBcAb检测。结果 3组年龄段检测人群HBsAb两种检测方法统计的阳性率无统计学差异,≤2岁组阳性率最高;HBcAb用CMIA法统计的阳性率在≤2岁组和2~20岁组的免疫人群组低于ELISA法。 92例样本用CMIA法检测HBcAb阳性率为2.2%;用3种ELISA法试剂检测阳性率分别为79.3%、82.6%及94.6%;3种ELISA法试剂检测阳性率无统计学差异。92例样本改变操作模式,用同种ELISA法检测试剂检测结果有19例为阴性,差异有统计学意义。结论 检测人群HBsAb检出率在2岁及以下人群最高,随年龄增长抗体下降。 HBcAb用CMIA法检测在免疫人群中检出阳性率明显低于EIISA法。ELISA竞争抑制一步法检测HBcAb易造成假阳性,如改用HBcAb单项加样操作或选用化学发光微粒子免疫检测法(CMIA)检测,可明显减少假阳性。

Prevalence of anti-HBV antibody among immunized population and evaluation of different detection methods of anti-HBc antibody

In this study, we detected the positive rate of anti-HBs and anti-HBc antibody among the subject population in Fujian Medical University Union Hospital, and to evaluate different detection methods of anti-HBc antibody. The positive rate of anti-HBs and anti-HBc antibody were detected by chemiluminescent microparticle immunoassay (CMIA) and one-step competitive enzyme-linked immunosorbent assay (ELISA) from the year 2012 to 2013. The subject population was divided into three groups: group 1 with the age of less than 2 years old, group 2 with the age of 2-20 years old, and group 3 with the age of more than 20 years old. The positive rates of anti-HBV antibody in the different groups were analyzed. Furthermore, anti-HBc antibody of 92 samples selected from the immunized population was detected by CMIA and three kinds of ELISA reagents. Meanwhile, the detection of anti-HBc antibody by the same ELISA reagent but different operating modes were performed in these samples. The highest positive rate of anti-HBs antibody was detected in group 1, and there was no significance difference of positive rate between two detection methods of anti-HBs antibody among three groups. The positive rate of anti-HBc antibody using CMIA was significantly lower than those with ELISA among group 1 and 2. Among the 92 samples, the positive rate of anti-HBc antibody was 2.2% using CMIA. With three kinds of method of ELISA reagent, the positive rate of anti-HBc antibody were 79.3%, 82.6% and 94.6%, respectively, and there was no statistical significance among the results of three ELISA reagents. Anti-HBc was not detected from 19 samples using ELISA methods with different operating modes. It's concluded that the anti-HBs antibody declined with the increase of age, and it is necessary to discriminate the specific population to strengthen immune system. The obviously higher positive rate of anti-HBc antibody was found by ELISA in immunized population than that by CMIA. Concerning on the false positive of ELISA, specimen sampling with one specific test item or the CMIA method was recommended to detect the anti-HBc antibody.