中华航空航天医学杂志
中華航空航天醫學雜誌
중화항공항천의학잡지
CHINESE JOURNAL OF AEROSPACE MEDICINE
2012年
2期
128-133
,共6页
厉淑红%宋平%戚红%孙晓明%陆龙%赵青
厲淑紅%宋平%慼紅%孫曉明%陸龍%趙青
려숙홍%송평%척홍%손효명%륙룡%조청
肝炎病毒,乙型%生物学标记物%DNA,病毒%体格检查%人员选用
肝炎病毒,乙型%生物學標記物%DNA,病毒%體格檢查%人員選用
간염병독,을형%생물학표기물%DNA,병독%체격검사%인원선용
Hepatitis B virus%Biological marker%DNA,viral%Physical examination%Personnel selection
目的 调查招飞学生HBV血清标志物模式及分布特点,探讨聚合酶链反应(polymerase chain reaction,PCR)荧光探针法与酶联免疫吸咐测定(enzyme linked immunosorbent assay,ELISA)在招飞体检HBV筛查中的应用价值. 方法 对象为参加本区招飞体检的学生(包括应届高中生、大学生)3843名.按出生年分为1992年前和1992年后(包括1992年)两个年龄组；根据户籍种类分为农村和城市学生.乙肝血清标志物采用ELISA法进行HBsAg、HBsAb、HBeAg、HBeAb及HBcAb共5项定性检测,按随机数字法随机抽取不同模式(除单项HBsAb阳性外)标本365例,采用PCR荧光探针法进行HBV-DNA定量检测. 结果 ①共检出13种HBV血清标志物模式,主要为HBsAb(+)模式；其次为5项全阴模式,HBsAb(+)、HBcAb(+)模式,HBsAb(+)、HBeAb(+)、HBcAb(+)模式,HBcAb(+)模式；HBsAg阳性以HBsAg(+)、HBeAg(+)、HBcAb(+)及HBsAg(+)、HBeAb(+)、HBcAb(+)模式为主,分别占HBsAg阳性总数的38.75％和46.25％.②两个年龄组HBsAb(+)模式,HBsAb(+)、HBeAb(+)模式和HBcAb(+)模式检出率差异有统计学意义(x2 =9.350、8.563,P＜0.01)；其他模式检出率差异无统计学意义(P＞0.05).③农村与城市学生相比,除HBsAb(+)、HBeAb(+)、HBcAb(+)模式和HBcAb(+)模式外,其他5种常见模式检出率差异有统计学意义(x2=4.592～34.838,P＜0.01或P＜0.05).④HBV-DNA定量检测病毒载量＞1000 copies/ml者62例,其中HBsAg阳性者占77.42％,其他模式占22.58％.HBsAg(+)、HBeAg(+)、HBcAb(+)者HBV-DNA检出率为95.45％(21/22),病毒载量为9.16×106～9.81×107copies/ml.HBsAg(+)、HBeAb(+)、HBcAb(+)者HBV-DNA检出率为45.71％(16/35),病毒载量为1.24×104～7.95×105 copies/ml.HBsAg(+)、HBeAg(+)者均检出HBV-DNA,病毒载量为(2.39～5.34)×107 copies/ml. 结论 ELISA法检测HBV血清标志物与PCR定量检测HBV-DNA相结合,有助于解决招飞体检HBV携带者误诊和漏检问题.
目的 調查招飛學生HBV血清標誌物模式及分佈特點,探討聚閤酶鏈反應(polymerase chain reaction,PCR)熒光探針法與酶聯免疫吸咐測定(enzyme linked immunosorbent assay,ELISA)在招飛體檢HBV篩查中的應用價值. 方法 對象為參加本區招飛體檢的學生(包括應屆高中生、大學生)3843名.按齣生年分為1992年前和1992年後(包括1992年)兩箇年齡組；根據戶籍種類分為農村和城市學生.乙肝血清標誌物採用ELISA法進行HBsAg、HBsAb、HBeAg、HBeAb及HBcAb共5項定性檢測,按隨機數字法隨機抽取不同模式(除單項HBsAb暘性外)標本365例,採用PCR熒光探針法進行HBV-DNA定量檢測. 結果 ①共檢齣13種HBV血清標誌物模式,主要為HBsAb(+)模式；其次為5項全陰模式,HBsAb(+)、HBcAb(+)模式,HBsAb(+)、HBeAb(+)、HBcAb(+)模式,HBcAb(+)模式；HBsAg暘性以HBsAg(+)、HBeAg(+)、HBcAb(+)及HBsAg(+)、HBeAb(+)、HBcAb(+)模式為主,分彆佔HBsAg暘性總數的38.75％和46.25％.②兩箇年齡組HBsAb(+)模式,HBsAb(+)、HBeAb(+)模式和HBcAb(+)模式檢齣率差異有統計學意義(x2 =9.350、8.563,P＜0.01)；其他模式檢齣率差異無統計學意義(P＞0.05).③農村與城市學生相比,除HBsAb(+)、HBeAb(+)、HBcAb(+)模式和HBcAb(+)模式外,其他5種常見模式檢齣率差異有統計學意義(x2=4.592～34.838,P＜0.01或P＜0.05).④HBV-DNA定量檢測病毒載量＞1000 copies/ml者62例,其中HBsAg暘性者佔77.42％,其他模式佔22.58％.HBsAg(+)、HBeAg(+)、HBcAb(+)者HBV-DNA檢齣率為95.45％(21/22),病毒載量為9.16×106～9.81×107copies/ml.HBsAg(+)、HBeAb(+)、HBcAb(+)者HBV-DNA檢齣率為45.71％(16/35),病毒載量為1.24×104～7.95×105 copies/ml.HBsAg(+)、HBeAg(+)者均檢齣HBV-DNA,病毒載量為(2.39～5.34)×107 copies/ml. 結論 ELISA法檢測HBV血清標誌物與PCR定量檢測HBV-DNA相結閤,有助于解決招飛體檢HBV攜帶者誤診和漏檢問題.
목적 조사초비학생HBV혈청표지물모식급분포특점,탐토취합매련반응(polymerase chain reaction,PCR)형광탐침법여매련면역흡부측정(enzyme linked immunosorbent assay,ELISA)재초비체검HBV사사중적응용개치. 방법 대상위삼가본구초비체검적학생(포괄응계고중생、대학생)3843명.안출생년분위1992년전화1992년후(포괄1992년)량개년령조；근거호적충류분위농촌화성시학생.을간혈청표지물채용ELISA법진행HBsAg、HBsAb、HBeAg、HBeAb급HBcAb공5항정성검측,안수궤수자법수궤추취불동모식(제단항HBsAb양성외)표본365례,채용PCR형광탐침법진행HBV-DNA정량검측. 결과 ①공검출13충HBV혈청표지물모식,주요위HBsAb(+)모식；기차위5항전음모식,HBsAb(+)、HBcAb(+)모식,HBsAb(+)、HBeAb(+)、HBcAb(+)모식,HBcAb(+)모식；HBsAg양성이HBsAg(+)、HBeAg(+)、HBcAb(+)급HBsAg(+)、HBeAb(+)、HBcAb(+)모식위주,분별점HBsAg양성총수적38.75％화46.25％.②량개년령조HBsAb(+)모식,HBsAb(+)、HBeAb(+)모식화HBcAb(+)모식검출솔차이유통계학의의(x2 =9.350、8.563,P＜0.01)；기타모식검출솔차이무통계학의의(P＞0.05).③농촌여성시학생상비,제HBsAb(+)、HBeAb(+)、HBcAb(+)모식화HBcAb(+)모식외,기타5충상견모식검출솔차이유통계학의의(x2=4.592～34.838,P＜0.01혹P＜0.05).④HBV-DNA정량검측병독재량＞1000 copies/ml자62례,기중HBsAg양성자점77.42％,기타모식점22.58％.HBsAg(+)、HBeAg(+)、HBcAb(+)자HBV-DNA검출솔위95.45％(21/22),병독재량위9.16×106～9.81×107copies/ml.HBsAg(+)、HBeAb(+)、HBcAb(+)자HBV-DNA검출솔위45.71％(16/35),병독재량위1.24×104～7.95×105 copies/ml.HBsAg(+)、HBeAg(+)자균검출HBV-DNA,병독재량위(2.39～5.34)×107 copies/ml. 결론 ELISA법검측HBV혈청표지물여PCR정량검측HBV-DNA상결합,유조우해결초비체검HBV휴대자오진화루검문제.
Objective To conclude the characters of serum marker pattern and distribution of hepatitis B virus (HBV) in pilot candidates and to investigate the value of applying polymerase chain reaction (PCR),fluorescent probe and enzyme linked immunosorbent assay (ELISA) in screening hepatitis B virus for pilot recruitment. Methods Three thousand eight hundred and forty-three students were chosen as subjects and were divided into 2 age groups by the birth year of 1992.They were also grouped by where they come from-rural and urban group.Hepatitis B serum marker was qualitatively measured by ELISA upon hepatitis B surface antigen (HBsAg),hepatitis B surface antibody (HBsAb),hepatitis B e antigen (HBeAg),hepatitis B e antibody (HBeAb) and hepatitis B core antibody (HBcAb).HBV-DNA was then quantitatively determined for 365 cases with different patterns [except HBsAb( +)] that were screened according to the table of random number. Results ① There were totally 13 serological patterns of HBV.The most common pattern was HBsAb(+),then the patterns along descending sequence were the negative in all 5 HBV serum makers,HBsAb (+) & HBcAb (+),HBsAb (+) & HBeAb (+) & HBcAb (+),and HBcAb (+).Positive HBsAg was mainly expressed as HBsAg (+) & HBeAg (+) & HBcAb (+) (38.75％ ),and HBsAg (+) & HBeAb (+) & HBcAb (+) (46.25％).② The rate of screening the patterns of HBsAb ( +),HBsAb (+) & HBeAb ( +),and HBcAb (+) showed statistical significance between age groups(x2 =9.350,8.563,P＜0.01),but for the other patterns (P＞0.05).③ Except for the patterns of HBsAb (+) &HBeAb (+) & HBcAb (+) and HBcAb (+) the screening rate of other 5 patterns showed significant difference between rural and urban groups (x2=4.592 ～ 34.838,P＜0.01 or P＜0.05 ).④ The cases of having virus ＞1000 copies/ml by quantitative measurement of HBV-DNA were 62.Among which,HBsAg (+) took 77.42％ while other patterns accounted 22.58％.The detection rate of HBsAg (+) & HBeAg (+) & HBcAb (+) by means of HBV-DNA was 95.45％ (21/22) and the virus load was from 9.16×106 to 9.81×107 copies/ml.45.71％(16/35) HBsAg (+) & HBeAb (+) & HBcAb (+) was detected by HBV-DNA and the virus load was from 1.24 × 104 to 7.95 × 105 copies/ml.All HBsAg (+) & HBeAg (+) could be detected by HBV-DNA and virus load was from 2.39 × 107 to 5.34 × 107 copies/ml. Conclusions Combining the detection of HBV serum marker by ELISA and PCR quantitive measurement of HBV-DNA would be helpful to reduce the misdiagnosis and missed diagnosis of HBV in pilot recruitment.
