【摘要】 目的 研究化学发光免疫分析法（CIA）在隐匿性乙型肝炎病毒（HBV）筛查中的价值。方法 选取2019年5—12月于清远市妇幼保健院进行HBV筛查的患者60例，所有患者均采用CIA进行HBV五项检测进行初筛，将初筛中乙型肝炎表面抗原（HBsAg）（-）、乙肝核心抗体（HBcAb）（+）样本进行复筛，并采用实时荧光定量聚合酶链式反应（FQ-PCR）法检测各样本中HBV DNA病毒载量，统计CIA检测情况以及HBsAg（-）、HBcAb（+）样本复筛及HBV DNA检测情况。结果 60例HBV样本CIA结果检出HBsAg（+）15例，阳性率为25.00%,HBsAg（-）、HBcAb（+）样本39例。以HBV DNA检测结果作为金标准，ELISA检测灵敏度为46.67%，特异度为66.67%;CIA检测灵敏度为86.67%，特异度为91.67%；与ELISA比较，CIA检查灵敏度、特异度更高（χ2=5.400、4.547,P=0.020、0.033）。结论 CIA检测HBsAg具有较高的灵敏度，但当样本存在HBsAg（-）、HBcAb（+）的情况下，需进行复筛和FQ-PCR HBV DNA检测，以免造成漏诊的情况。更多还原

【Abstract】 Objective To study the value of chemiluminescence immunoassay（CIA） in screening occult hepatitis B virus（HBV）. Methods A total of 60 patients who underwent HBV screening at Maternal and Child Health Hospital of Qingyuan City from May to December 2019 were selected as study subjects. All patients were initially screened for the five HBV markers by CIA, and samples of hepatitis B surface antigen（HBsAg）（-） and hepatitis B core antibody（HBcAb）（+） undergoing the initial screening were re-screened. The realtime fluorescence quantitative polymerase chain reaction（FQ-PCR） was used to detect the viral load of HBV DNA in each sample, and the CIA results and the re-screening and HBV DNA detection results of HBsAg（-）and HBcAb（+） samples were counted. Results In the CIA results of 60 HBV samples, 15 cases of HBsAg（+）samples were detected, with a positive rate of 25.00%, and 39 cases of HBsAg（-） and HBcAb（+） samples were detected. Using HBV DNA detection results as the gold standard, the sensitivity was 46.67% and the specificity was 66.67% for the detection by enzyme-linked immunosorbent assay（ELISA）, and the sensitivity was 86.67%and the specificity was 91.67% for the detection by CIA. Compared with ELISA, CIA has higher sensitivity and specificity（χ2=5.400,4.547;P=0.020,0.033）. Conclusion CIA has a high sensitivity for detecting HBsAg, but when HBsAg（-） and HBcAb（+） are present in the sample, re-screening and HBV DNA detection by FQ-PCR are needed to avoid missed diagnosis.更多还原