酶联免疫法筛查HIV抗体在艾滋病诊断中的应用价值

目的 对比在艾滋病检验中HIV抗体ELISA法筛查结果与免疫印迹试验结果,探讨HIV抗体筛查在艾滋病诊断中的临床价值.方法 选取2000年1月-2014年1月于海军总医院门诊或住院部术前或输血前患者79 231例,对所有患者抽血,采用EHSA方法对HIV抗体进行初筛检测,将阳性标本进行ELISA复核检测及免疫印迹试验确证,记录各标本复核结果及确证结果,并利用SPSS软件进行对比分析.结果 初筛结果阳性189例,复核结果双阳性186例,初筛与确证结果符合率为96.77％,其中2例经确证为阴性,4例确证结果为不确定.确证为阳性、阴性及不确定的HIV抗体初筛样本结果S/CO值分别为9.9 ～38(17.02 ±3.19)、1～5.8(5.18 ±0.48)、6～9.9(7.94±2.34).1＜S/CO值＜5.9、6＜S/CO值＜9.9及S/CO值＞9.9的样本确证试验阳性符合率分别为33.33％、85.71％,、98.22％.189例初筛阳性样本确诊结果阳性符合率为95.24％,确证试验共出现11条反应带,出现频率由高到低依次为gp160、gp24、gp120、gp41、p66、p51、p31、p17、p55、p39和p36,前4者出现率为95％以上.结论 通过ELISA方法进行HIV抗体筛查阳性率高,但存在一定的假阳性率,其阳性符合率与S/CO值呈正相关性,虽然高S/CO值不能证明其HIV感染,但它是艾滋病诊断中有效的方法.

The clinical value of HIV antibody screening by ELISA in diagnosis of AIDS

Objective To investigate the clinical value of HIV antibody screening in diagnosis of AIDS by comparing the ELISA results in HIV antibody screening with the results of Western Blot(WB).Methods From January 2000 to January 2014,79 231 samples from patients in outpatient or from patients before receiving surgery or blood transfusion in the inpatient departments of the Navy General Hospital were selected and examined by ELISA for HIV antibody screening.The positive samples were re-tested by ELISA and confirmed by WB.The results for re-tests and confirmatory testes were recorded.The data were analyzed by SPSS software.Results One hundred and eighty nine samples were positive in screening.There were 186 positive cases after re-testes,including 2 cases of confirmed negative and 4 cases of uncertain after confirmatory tests.The coincidence rates of positive between re-test and confirmatory test were 96.77％.Among 189 positive results of HIV antibody screening tests,the S/CO value of samples confirmed to be positive,negative and uncertain were 9.9 ～ 38(17.02 ± 3.19),1 ～ 5.8 (5.18 ± 0.48) and 6 ～ 9.9 (7.94 ± 2.34),respectively.For the screening test results of 1 ＜ S/CO ＜ 5.9,6 ＜ S/CO ＜ 9.9 and S/CO ＞9.9,the coincidence rates of having positive confirmatory results were 33.33％,85.71％ and 98.22％,respectively.The overall coincidence rate of screening and confirmatory results in the 189 positive cases in HIV antibody screening was 95.24％.The 11 reaction zones of confirmatory test,from high to low frequency of occurrence were gp160,gp24,gp120,gp41,p66,p51,p31,p17,p55,p39 and p36.The occurrence rates of the first 4 reaction zones were above 95％.Conclusions The positive rate of HIV antibody screening by ELISA was high,but there were possible false-positive cases.The coincidence rate had positive correlation with the S/CO values.Although the high S/CO could not prove the patients HIV infection,it could be an effective indicator in AIDS diagnosis.