【摘要】 目的评价丙型肝炎病毒核心抗原(hepatitis C virus core antigen,HCV-cAg)及丙型肝炎病毒RNA(hepatitis C virus RNA,HCV RNA)检测在慢性丙型肝炎(chronic hepatitis C,CHC)诊断中的作用。方法收集2013年6月至2014年5月我院186例丙肝抗体阳性的CHC患者,分别采用酶联免疫吸附试验及荧光定量逆转录聚合酶链反应(fluorescence quantitative reverse transcription polymerase chain reaction,FQ-RT-PCR)法检测患者HCV-cAg及HCV RNA水平,并对检测结果进行统计学分析。结果在186例CHC患者中,HCV-cAg阳性检出率为33.87%,HCV RNA阳性检出率为53.23%,二者差异有统计学意义(P<0.05);以HCVRNA检测为病毒血症金标准,HCV-cAg的灵敏度和特异性分别为60.61%、96.55%,阳性预测值和阴性预测值分别为95.24%、68.29%。随着患者血清HCV RNA水平的降低,HCV-cAg阳性率也呈现下降趋势,且各组间比较差异有统计学意义(P<0.05)。HCV-cAg阳性组HCV RNA病毒载量及阳性率均高于HCV-cAg阴性组,两组间差异均有统计学意义(P均<0.01)。结论FQ-RT-PCR技术检测HCV RNA是判断HCV感染最可靠的方法,而HCV-cAg诊断病毒复制有一定的局限性,但可作为病毒存在和复制指标的重要补充。更多还原

【Abstract】 Objective To evaluate the clinical significance of hepatitis C virus core antigen(HCVcAg) and hepatitis C virus RNA(HCV RNA) detection on diagnosis of chronic hepatitis C(CHC).Methods The serum samples from a total of 186 chronic HCV infected patients with positive anti-HCV were collected in our hospital from June 2013 to May 2014.HCV-cAg and HCV RNA were detected by sandwich ELISA and fluorescence quantitative reverse transcription polymerase chain reaction(FQ-RT-PCR) respectively,and the data were further analyzed statistically.Results The positive rate of HCV-cAg was 33.87% and the positive rate of HCV RNA was 53.23% from all of 186 patients,and the difference had statistical significance(P<0.05).When took the HCV RNA as the gold standard,the sensitivity and specificity of HCV-cAg assay were60.61% and 96.55% respectively,the positive predictive value and negative predictive value were 95.24% and68.29%.The positive rate of HCV-cAg showed a downtrend along with the decreased of HCV RNA viral load,and the difference had statistical significance(P<0.05).HCV RNA viral load and positive rate in HCV-cAg positive group were all higher than that of HCV-cAg negative group,and the differences all had statistical significance(Pall<0.01).Conclusion HCV RNA quantitation by FQ-RT-PCR technique is still the most reliable method for evaluating the status of HCV infection.Although HCV-cAg assay has some limitations,but it can be a useful supplemental indicator for monitoring the existence and replication of HCV in clinical practice.更多还原