孙健

【摘要】 目的：探讨酶联免疫法与化学发光法检测丙型肝炎病毒抗体的对比性研究及对特异度的影响。方法：选取2018年1-12月于本院进行丙型肝炎病毒抗体检查的患者568例，所有患者均进行酶联免疫法与化学发光法检测。分析重组免疫印迹法（RIBA）确证酶联免疫法结果，RIBA法确证化学发光法结果，比较酶联免疫法与化学发光法检测的准确度、灵敏度、特异度。结果：RIBA法确诊的阳性标本为11例（1.9%），酶联免疫法检查结果，阳性标本为65例（11.4%），化学发光法检查结果，阳性标本为34例（6.0%）。化学发光法准确度、特异度均高于酶联免疫法，两种方法差异有统计学意义（P<0.05）;两种方法灵敏度比较，差异无统计学意义（P>0.05）。结论：丙型肝炎病毒抗体检测中，化学发光法的准确度、特异度高于酶联免疫法，通过化学发光法可以有效提高临床监测准确度，但是对酶联免疫法与化学发光法检测均存在可疑现象时，需使用RIBA再次进行确定。

【关键词】 酶联免疫法 化学发光法 丙型肝炎病毒抗体 特异度

[Abstract] Objective： To explore the comparative study on enzyme-linked immunosorbent assay （ELISA） and chemiluminescence （CL） in the detection of hepatitis C virus （HCV） antibody and its effect on specificity. Method： A total of 568 patients tested for hepatitis C virus antibody were selected from our hospital from January to December 2018. All patients were tested by ELISA and CL. Recombinant western blotting （RIBA） was used to confirm the results of ELISA， RIBA was used to confirm the results of CL. The accuracy， sensitivity and specificity of ELISA and CL were compared. Result： There were 11 cases （1.9%） positive specimens confirmed by RIBA， 65 cases （11.4%） positive specimens confirmed by ELISA， the chemiluminescence were positive in 34 cases （6.0%）. The accuracy and specificity of CL method were higher than that of ELISA， the differences between the two methods were statistically significant （P<0.05）. There was no significant difference in the sensitivity between the two methods （P>0.05）. Conclusion： In the detection of hepatitis C virus antibody， the accuracy and specificity of CL are higher than that of ELISA. CL can effectively improve the accuracy of clinical monitoring and reduce the missed diagnosis. However， if there are suspicious phenomena in the detection of ELISA and CL， RIBA should be used to determine again.

[Key words] Enzyme-linked immunosorbent assay Chemiluminescence Hepatitis C virus antibody Specificity

丙型肝炎主要是由丙肝病毒（HCV）引发的慢性严重疾病，该疾病的传播方式主要为肠道外传播;当患者感染该病毒后肝脏组织也会受到损伤[1]。且患者感染初期并没有明显的症状，这就不容易及时发现病情，当发生明显的症状时已经处于病情较为严重阶段，有的患者还会演变为肝硬化、慢性肝炎、肝癌等。故对患者及时进行丙肝病毒抗体检测十分重要。但是在检测患者的时候选择更加经济、快速、准确的检测方法非常关键。当前很多医院都是使用酶联免疫法检测，随着方法的不断增多，化学发光法逐渐使用，该方法的特点是线状范围宽、灵敏度高[2]，但是两种方法究竟谁更好还需要进一步研究。……