不同检测方法在吸毒人群筛查丙肝中应用价值.docVIP

不同检测方法在吸毒人群筛查丙肝中的应用价值 　　[摘要] 目的 探讨不同检测方法在吸毒人群筛查丙肝中的应用价值。 方法 选取2014年1～8月中山市第二人民医院“美沙酮门诊”定点收治的吸毒史部分患者194例，采用HCV-cAg ELISA试剂盒，HCV-Ab ELISA试剂盒，HCV-RNA PCR试剂盒分别检测。 结果 194例吸毒患者血样，HCV-RNA PCR阳性率为58.76%（114/194），HCV-Ab阳性率为63.92%%（124/194），HCV-cAg阳性检出率为32.47%（63/194）。HCV-Ab标志物阳性率显著高于HCV-cAg（χ2=38.411，P0.01）。在HCV-Ab阴性样本中，有5例HCV-cAg阳性，其中4例HCV-RNA PCR结果阳性。 结论 不同检测方法的检测效果略有差异，临床上可考虑HCV-cAg与HCV-Ab联合检测优势互补，对吸毒高危人群联合筛查，将有效防止漏检。 　　[关键词] 丙型肝炎病毒；丙肝病毒核心抗原；丙肝病毒抗体；联合检测 　　[中图分类号] R512.6+3 [文献标识码] A [文章编号] 1674-4721（2016）03（c）-0129-03 　　[Abstract] Objective To explore the application value of different determination method in screening hepatitis C in drug users. Methods 194 patients with history of drug use sentinel treated by adanon outpatientin the Second People′s Hospital of Zhongshan City from January to August 2014 were selected.HCV-cAg ELISA kit，HCV-Ab ELISA kit and HCV-RNA PCR kit was respectively used to detect. Results Among 194 samples from drug users，the positive rate of HCV-RNA PCR was 58.76% （114/194），the positive rate of HCV-Ab was 63.92% （124/194），the positive detection rate of HCV-cAg was 32.47% （63/194）.The positive rate of HCV-Ab markers was obviously higher than t of HCV-cAg （χ2=38.411，P0.01）.Among HCV-Ab negetive samples，5 cases were HCV-cAg positive and 4 cases with HCV-RNA PCR positive results among that. Conclusion The detection effect of different determination method has lightly difference，HCV-cAg and HCV-Ab of combination detection may be considered for their complement each other′s advantages.Using combination screening to high-risk drug users can prevent missed detection effectively. 　　[Key words] Hepatitis C virus；HCV-cAg；HCV-Ab；Combined detection 　　丙型肝炎（丙肝）在我国属乙类传染病[1]，其病原体是丙型肝炎病毒（hepatitis C virus，HCV）[2]。据文献报道全球约有2亿人感染，感染率为3%，每年因HCV相关疾病死亡人数达35万之多，中国约有4000万人感染，感染率为3.2%，略高于全球平均水平[3-4]，而这些感染者中，60%为吸毒人员[5-6]。号称“沉默杀手”的丙肝具有隐匿性、慢性化特征，并可发展为肝硬化、肝癌，但因HCV具有高度变异性，目前尚无理想的预防性疫苗和特效药物治疗，只能采取保肝护肝治疗[7-8]，因此，建立早期、快速、准确、价廉的筛查方法，选择合适的检测策略，对HCV的防控和预后有重大意义。丙肝病毒抗体（HCV-Ab）、HC