段美婷　兰良子

[摘 要] 目的：比较化学发光法与酶联免疫吸附法在血液HIV检测中的应用效果。方法 ：对本院2014年 3月至 2015年 9月期间所有术前检查病人利用化学发光法和酶联免疫吸附法进行HIV筛查试验检测。结果：35420例病人血清标本中，化学发光法和酶联免疫吸附法均判定阳性29例，金标准免疫印迹法（WB）确定25例为阳性，4例为阴性。化学发光法阳性酶联免疫吸附法阴性的10例，WB检测结果阳性8例，阴性2例。化学发光法比酶联免疫吸附法真阳性率高，但是假阳性率也增加。通过对比S/CO不同值，发现化学发光法假阳性率出现在S/CO≤500，并且随着S/CO值降低，假阳性率升高明显；S/CO>500，化学发光法准确性明显升高。结论与酶联免疫吸附法相比，在一定范围内，化学发光法更适用血液HIV筛查。

[关键词] 化学发光法；酶联免疫吸附法；人类免疫缺陷病毒

中图分类号：R446 文献标识码：B 文章编号：2095-5200（2016）05-078-03

[Abstract] Objective： To compare the application effects of chemical luminescence method method and enzyme-linked immunosorbent assay on the detection of HIV in blood. Methods： All patients in our hospital from March 2014 to September 2015 were examined by using chemiluminescence and enzyme-linked immunosorbent assay for HIV screening test. Results： In 35420 cases of serum samples， 29 cases were both positive through the methods of chemiluminescence and enzyme-linked immunosorbent assay， and the gold standard Western blotting （WB） confirmed that 25 cases were positive and 4 cases were negative. 10 cases were tested for positive through chemical luminescence method method but for negative through enzyme linked immunosorbent assay， and its WB test results were positive in 8 cases， negative in 2 cases. The true positive rate of chemical luminescence method method was higher than that of enzyme-linked immunosorbent assay， but the false positive rate was also increased. Through the comparison of different S/CO values， we found that the false positive rate of using chemical luminescence method method occurred as S/CO≤500， and with the decrease of S/CO value， false positive rate increased significantly； as S/CO>500， the accuracy of chemical luminescence method increased significantly. Conclusions： Compared with the enzyme-linked immunosorbent assay in a certain range， the chemical luminescence method is more suitable for HIV screening in blood.

[Key words] CLIA； Elisa； HIV

获得性免疫缺乏综合征简称艾滋病（AIDS），是由人类免疫缺陷病毒（human immunodeficiency virus， HIV）引起的一种严重传染性疾病。酶联免疫吸附法（Elisa）最早应用于艾滋病毒的筛查，1985年研制成功的第一代HIV Elisa试剂[2]敏感性和特异性欠佳，至今已发展至第四代。Gag基因编码HIV病毒核心蛋白包括p17、p24、p15[3-7]，P24在血清转换的很短时期内就可以被第四代试剂检测出来，因此第四代HIV Elisa试剂将检测的“窗口期”从三代的22天左右减少到16天左右[8]。

化学发光法（CLIA）的主要原理[9]是将酶免疫发光物质标记在抗原或抗体上，加入氧化剂或酶底物而发光，通过标准曲线测定发光强度来确定待测物的含量。本实……