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【摘要】 目的：探讨荧光定量逆转录聚合酶链反应（FQ-PCR）、酶联免疫吸附试验（ELISA）联合检测丙型肝炎病毒的临床意义。方法：用FQ-PCR联合ELISA方法检测117例临床已确诊为丙型肝炎患者的血清，同时检测它们的丙氨酸氨基转移酶（AAT）。结果：①抗-HCV阳性率随着HCV-RNA含量的升高而增高，其阳性率与HCV-RNA含量呈正相关。②87例HCV-RNA阳性标本中，有50例ALT异常，其异常率随着HCV-RNA含量的升高而增高，ALT异常率与HCV-RNA含量呈正相关， ALT水平和HCV-RNA含量之间呈正相关。③FQ-PCR检测敏感性为74.4%(87/117)，漏检率为25.6%（30/117）。ELISA法检测敏感性为76.9%（90/117），漏检率为23.1%（27/117）。两种方法联合检测敏感性为92.3%(108/117)，漏检率为7.7%（9/117）。结论：两种方法联合检测，互相补充，大大提高了丙型肝炎病毒的检出率，为临床早期，准确诊断丙型病毒肝炎、监测病情、观察疗效提供了有力的依据，为献血人员筛选和血制品安全提供了有力保障。 【关键词】 丙型肝炎病毒核酸；丙型肝炎病毒抗体；荧光定量逆转录聚合酶链反应；酶联免疫吸附试验；丙氨酸氨基转移酶
Detection of hepatitis C virus by FQ-PCR and ELISA: Clinical application
GAO Yingying，MA Lei，SUN Yuhong
1.The Clinical Medical College of Jiamusi University, Jiamusi 154003,China;2.The First Affiliated Hospital of Jiamusi University, Jiamusi 154003,China
Abstract:Objective:To discuss the clinical significance of detection of hepatitis C virus by FQ-PCR and ELISA.Methods:We detected of 117 sera of clinical patients who had been diagnosed as hepatitis C,and at the same time tested their alanine aminotransferase(AAT).Results:① Anti-HCV's positive rate rose with HCV-RNA content increase. By using correlation analysis,anti-HCV positive rate and HCV-RNA content showed positive correlation.②There were 50 AAT abnormal ones in 87 HCV-RNA positive samples.AAT abnormal rate rose with HCV-RNA content increase,showing positive correlation by using correlation analysis, and there was a positive correlation between the AAT level and HCV-RNA content.③FQ-PCR detection sensitivity was 74.4%(87/117),and omission factor was 25.6%（30/117）.ELISA detection sensitivity was 76.9%（90/117）,and omission factor was 23.1%（27/117）.Combined detection sensitivity of two kinds of methods was 92.3%(108/117),and omission factor was 7.7%（9/117）.Combined detection sensitivity was higher than that of separate.Conclusion:The combined detection is complementary,and greatly improves the hepatitis C virus detection rate,providing a powerful basis for clinical early and accurate diagnosis of hepatitis C virus,condition monitoring,and clinical observation, and providing a strong support for screening blood donors and safety of blood products.
Key words:HCV-RNA；anti-HCV；FQ-PCR；ELISA；AAT
作者：高英英，马雷，孙玉鸿 作者单位：佳木斯大学临床医学院检验系，黑龙江 佳木斯 154003；佳木斯大学附属第一医院检验科，黑龙江 佳木斯 154003
幸福检验网www.xf366.com 感谢作者对论文的分享
我国一般人群抗-HCV阳性率为3.2％［1］，急性丙型肝炎绝大多数都将形成慢性丙型肝炎，是形成肝硬化和肝癌的重要原因［2］。目前，医院和血站大多采用ELISA法检测血清中抗-HCV来诊断可疑感染者和筛选献血员。但ELISA法检测血清抗-HCV敏感性不高，存在30％左右的漏检率［3,4］，耽误了一部分患者疾病的治疗和引起输血后HCV感染的流行。因此，我们用FQ-PCR联合ELISA方法检测117例临床已确诊为丙型肝炎患者的血清，并同时检测血清ALT。探索能够提高丙型肝炎病毒检出率的方法，为临床诊断丙型病毒肝炎，判断病情和疗效提供参考依据。
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