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目的通过分析乙肝患者乙型肝炎病毒(HBV)血清标志物乙型肝炎表面抗原(HBsAg)与乙型肝炎表面抗体(HBsAb)同时阳性罕见模式的病例,探讨其存在原因及临床价值。方法应用ELISA法对乙肝感染者HBV标志物进行初筛,再采用微粒子酶免疫化学发光分析法(MEIA)检测其浓度;对HBsAg与HBsAb同时阳性者应用PCR方法定量检测HBV-DNA,并结合患者的临床特点进行综合分析。结果 HBsAg与HBsAb同时阳性的检出率为4.46%,检出率最高为重型肝炎(18.18%),其次为慢性肝炎(9.09%)和肝硬化(8.96%)。重型肝炎、慢性肝炎和肝硬化HBsAg与HBsAb同时阳性率明显高于无症状携带者和急性肝炎(P<0.01)。HBsAg高滴度组HBV-DNA病毒载量及阳性率明显高于低滴度组(P<0.01)。HBs-Ab值与HBV-DNA病毒载量间无明显相关性(P>0.05)。结论 HBsAg与HBsAb同时阳性的模式,是由多种原因引起,HBV亚型双重感染可能是主要原因。
Objective To analyze the causes of hepatitis B virus (HBV) serum markers of hepatitis B surface antigen (HBsAg) and hepatitis B surface antigen (HBsAb) simultaneous positive rare cases of cases, to explore its causes and clinical value. Methods Hepatitis B virus (HBV) markers were preliminarily screened by ELISA. The concentrations of HBV markers were detected by microparticle enzyme immuno-chemiluminescence (MEIA). HBV-DNA was quantitatively detected by PCR in both HBsAg and HBsAb positive patients. The clinical features of a comprehensive analysis. Results The positive rate of HBsAg and HBsAb positive was 4.46%. The highest detection rates were severe hepatitis (18.18%), followed by chronic hepatitis (9.09%) and cirrhosis (8.96%). The positive rates of HBsAg and HBsAb in severe hepatitis, chronic hepatitis and cirrhosis were significantly higher than those in asymptomatic carriers and acute hepatitis (P <0.01). HBsAg high titer group HBV-DNA viral load and positive rate was significantly higher than the low titer group (P <0.01). There was no significant correlation between HBs-Ab value and HBV-DNA viral load (P> 0.05). Conclusions The mode of simultaneous positive of HBsAg and HBsAb is caused by a variety of reasons. Duplication of HBV subtype may be the main reason.