测定低水平血清乙肝病毒表面抗原及其临床意义

目的了解测定低水平血清乙肝病毒表面抗原（HBsAg）的人群分布及相关乙肝病毒血清标志物模式特征。方法微粒子酶免疫分析技术测定6186例非肝炎病区住院患者血清HBsAg及表面抗体（抗-HBs）、乙肝病毒e抗原及e抗体（HBeAg、抗-HBe）和乙肝病毒核心抗体（抗-HBc）,根据定值参比血清和样本的HBsAg荧光速率值/阴性对照荧光速率值的比值（S/N值）,并结合中和试验结果,确定浓度在5μg/L以下的HBsAg阳性例数,并分析相关乙肝病毒（HBV）血清标志物模式。结果共检出HBsAg阳性626例,HBsAg浓度在5μg/L以下的有158例,占总数的2.55%,占HBsAg阳性人群的25.24%。其中,HBsAg浓度在1μg/L以下的有71例（44.94%）;1～2μg/L的有26例（16.46%）;2～5μg/L的有61例（38.60%）。对上述低水平HBsAg人群的5项HBV血清标志物检测获得8种模式,以＂HBsAg、抗-HBc、抗-HBe阳性＂,＂HBeAg和抗-HBs阴性＂模式为主（74.60%）;累计HBsAg和抗-HBc同时阳性者占94.17%;HBsAg与抗-HHs同时阳性只出现在HBsAg1μg／L以下人群中（6．45％）。结论低水平血清HBsAg人群不容忽视，提高HBsAg检测灵敏度有重要意义；同时检测相关HBV血清标志物，对于确定上述人群有帮助。

Determination of low level HBsAg in serum and its clinical significance

Objictive To investigated the distribution of the population with low level HBsAg in serum and the characteristics of their HBV serologic maker.Methods Microparticle enzyme immunoassay determination of 6 186 hospitalized patients with non-endemic area of serum HBsAg and hepatitis B surface antibody （anti-HBs）,hepatitis B virus e antigen and e antibody （HBeAg,anti-HBe）and hepatitis B virus core antibody （anti-HBc）,according to valuation reference samples of serum and HBsAg fluorescence rate of the value/ negative control fluorescence rate of the value of the ratio of （S/N value）, and combinated the test results to determined concentration the number of HBsAg-positive that below 5μg/L, and analyzed the pattern of hepatitis B virus （HBV） serum marker. Results 626 cases were detected in HBsAg-positive, concentration of HBsAg below 5μg/L were 158 cases, accounting for 2.55 % of the total, accounting for 25.24% of HBsAg-positive people. Which, The following 1μg/L of HBsAg concentration were 71 cases （44.94%） ;1 -2μg/L were 26 cases （16.46%） ;2 -5μg,/L were 61 cases （38.60%）. These low-level HBsAg population had five cases HBV markers in serum obtained eight kinds of models to ＂HBsAg, anti-HBc, anti-HBe-positive＂, the majority was ＂HBeAg and anti-HBs-negative＂ mode （ 74.60% ） ; accumulated HB- sag and anti-HBc both positive of persons accounting for 94.17% ;HBsAg and anti-HHs also positive only in the populations whose HBsAg beloe 1μg/L（6.45% ）. Conclusion Low level of serum HBsAg crowd can not be ignored and it＇s important to improved the sensitivity of HBsAg detection, and detected the other HBV serologic markers was helpful to them.