戊型肝炎患者血清ORF2抗原的检测及临床意义

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目的:研究戊型肝炎患者戊型肝炎病毒(hepatitis E virus,HEV)-Ag与其他检测指标的相关关系,评价HEV-Ag检测在临床诊断戊型肝炎中的意义.方法:116例急性戊型肝炎患者血清标本应用酶联免疫吸附试验试剂盒进行抗HEV IgM、抗HEV IgG和HEV-Ag检测,应用RT-NestedPCR进行HEV RNA检测.通过比较分析血清中HEV-Ag与HEV RNA检测结果,对HEV-Ag检测的临床意义进行评价.结果:诊断为戊型肝炎的116例患者初次采集的血清进行HEV感染标志物的检测,其中55.2%(64/116)为HEV-Ag阳性.116例患者中分别有5、21、63和27例为抗HEV IgMIgG-、IgM+IgG-、IgM+IgG+和IgM-IgG+,这4组中HEV-Ag的检出率分别为100%、90.5%、61.9%和3.7%.64例抗原阳性样本中40例(62.5%,40/64)为HEV RNA阳性,而52抗原阴性样本中只有1例(1.9%,1/52)为HEV RNA阴性,对HEV-Ag检测和HEV RNA检测的结果进行相关性分析,Kappa指数为0.582,显示血清中HEV-Ag检测和HEV RNA检测具有比较好的一致性.结论:HEV-Ag与HEV RNA的检测结果具有较好的一致性,HEV-Ag检测有助于戊型肝炎的早期诊断及慢性感染的诊断. Objective: To study the correlation between hepatitis E virus (HEV) -Ag and other test indexes in patients with hepatitis E and to evaluate the significance of HEV-Ag test in clinical diagnosis of hepatitis E.Methods: 116 patients with acute type E Serum samples of patients with hepatitis were tested for anti-HEV IgM, anti-HEV IgG and HEV-Ag by ELISA kit and RT-NestedPCR for detection of HEV RNA.Through comparative analysis of HEV-Ag and HEV RNA in serum, HEV-Ag test.Results: Among the 116 patients with hepatitis E, the serum collected from the initial detection of HEV infection markers, of which 55.2% (64/116) positive for HEV-Ag.Results of 116 patients 5, 21, 63 and 27 were anti-HEV IgMIgG-, IgM + IgG-, IgM + IgG + and IgM-IgG + respectively. The detection rates of HEV-Ag in these 4 groups were 100%, 90.5%, 61.9 %, And 3.7%, respectively. Forty cases (62.5%, 40/64) of the 64 antigen positive samples were positive for HEV RNA, while only 1 (1.9%, 1/52) of the 52 negative samples were negative for HEV RNA. -Ag test and HEV RNA test results showed that the Kappa index was 0.582, which showed that the detection of HEV-Ag in serum and HEV RNA detection had better Consistency.Conclusion: HEV-Ag and HEV RNA test results have good consistency, HEV-Ag test is helpful for the early diagnosis of hepatitis E and the diagnosis of chronic infection.
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