丙型肝炎病毒总抗原检测用于病程监测的研究

目的探讨丙型肝炎病毒(HCV)总抗原检测方法在丙肝病程监测方面的临床意义。方法对来本院就诊的40位丙肝患者于治疗前、治疗1个月时、治疗3个月时、治疗6个月(停药)时,停药6个月后等不同时期进行采血,收集血清或血浆标本,用抗-HCV检测试剂盒(酶联免疫法)、HCV核酸(RNA)扩增(PCR)荧光定量检测试剂盒、HCV总抗原检测试剂盒(酶联免疫法)进行检测。结果从患者确认感染丙肝到治疗结束抗-HCV检测均呈阳性,而HCV-RNA检测和HCV总抗原检测会随着病程的变化而变化。本次共检测了189例标本(40位患者不同时期标本总例数),其中HCV-RNA阳性51例,该51例阳性标本中,HCV总抗原检测阳性44例,阳性检出率为86.27%;138例HCV-RNA阴性标本,有3例HCV总抗原检测为阳性(2.2%)。2种方法比较,差异无统计学意义(χ2=1.6,P>0.05)。HCV总抗原检测其OD值会随着病程的变化而相应改变,可以较好地反应丙肝患者的病程状况。结论 HCV总抗原检测方法在丙肝病程监测方面具有很好的临床意义,适合在缺少荧光定量PCR检测能力的中小医院使用,可在一定程度上替代HCV-RNA检测,对抗-HCV阳性患者作进一步的验证检测或补充,更好地应用于丙肝患者的病程监测。

Clinical investigation on the hepatitis C virus total antigen detection for monitoring of hepatitis C

Objective To investigate the clinical significance of total antigen detection in patients with chronic hepatitis C.Methods Sera from 40 consecutive patients with chronic hepatitis C were investigated for the presence of total antigen by ELISA,and the correlations with HCV RNA,and HCV antibody detection.Results From patients infected with hepatitis C to the end of treatment,HCV antibody tests results were all positive,but HCV-RNA detection and HCV total antigen test results would change with the fluctuations in the treatment regimen,that is,with the pathogenesis.We tested 189 samples(the total samples of the 40 patients in different period of onset),there were 51 positive samples of the HCV RNA detection results,and there were 44 positive of the 51 samples by HCV total antigen detection,the positive rate was 86.27%.There were 138 negative samples by HCV-RNA detection results,and the HCV total antigen results showed 3 positive samples.There was no significant differences(χ2 = 1.6,P > 0.05).Conclusion HCV antigen detection may help the diagnosis and treatment of chronic hepatitis C patients,especially in monitoring the course of the disease hepatitis C.It could be used as the substitution of the HCV-RNA detection in the medium hospitals thta are lack of RT-PCR detection.