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目的:探讨基层医院乙肝检测的检测策略。方法:从日常电化学发光法检测标本中选取1100例血清标本,其中包括1000例乙型肝炎病毒表面抗原阳性的样本,100例五项标志物全阴性样本。用胶体金法(GIA)乙肝五项检测卡与酶连免疫法(EIA)分别进行检测。结果:100例乙型肝炎病毒表面抗原阴性样本,两种方法检测结果一致,均为阴性;另外1000例酶连免疫法检测乙肝表面抗原项阳性率为96%,漏检率为4%。胶体金乙肝五项检测卡中表面抗原项阳性率为88%,且所有阳性标本均为酶联免疫检测乙肝表面抗原阳性样本。漏检样本均有乙型肝炎病毒核心抗体或乙型肝炎病毒e-抗体中的1项或2项阳性表现。结论:酶联免疫法敏感性大于胶体金方法,胶体金法特异性很好但敏感性不足。但由于乙肝五项卡中的核心抗体或e-抗体在8%(96%减88%)的差值中可有阳性表现,可作为进一步复查的警示。
Objective: To explore the detection strategies of hepatitis B in primary hospitals. Methods: A total of 1100 serum samples were selected from routine chemiluminescence detection samples, including 1000 positive samples of hepatitis B virus surface antigen and 100 negative samples of all five markers. Colloidal gold method (GIA) hepatitis B five test card and enzyme linked immunosorbent assay (EIA) were tested. Results: The negative samples of 100 cases of hepatitis B virus surface antigen were consistent with the results of the two methods. All of them were negative. In addition, the positive rate of HBsAg was 96% and the missed detection rate was 4%. Colloidal gold and hepatitis B five detection card surface antigen positive rate was 88%, and all positive specimens were ELISA positive samples of hepatitis B surface antigen. Negative samples were hepatitis B virus core antibody or hepatitis B virus e-antibody in one or two positive manifestations. Conclusion: The sensitivity of enzyme-linked immunosorbent assay is greater than that of colloidal gold method. The colloidal gold method has good specificity but not enough sensitivity. However, due to the hepatitis B five card core antibody or e-antibody in 8% (96% minus 88%) the difference between the positive performance can be used as a warning for further review.