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[中国9省乙肝监测实验室检测结果评估]

[Evaluation of the test results on hepatitis B pilot surveillance labortory in 9 provinces of China].

作者信息

Wang Fu-zhen, Cui Fu-qiang, Gong Xiao-hong

机构信息

Department of National Immunization Programme, Chinese Center for Disease Control and Prevention, Beijing 100050, China.

出版信息

Zhongguo Yi Miao He Mian Yi. 2010 Jun;16(3):203-6, 274.

Abstract

OBJECTIVE

To assess the test quality of HBsAg, anti-HBc IgM and anti-HAV IgM in the laboratories of Hepatitis B pilot surveillance provinces.

METHODS

Blood serum from each of the Hepatitis B pilot surveillance provinces were collected to verify the test results. The Chemiluminescence Microparticle Immuno Assay (CMIA), ARCHITECT i2000 automatic light detector and test reagents produced by U.S.A. Abbott corporation were used in the retest. Using the Abbott reagent CMIA test results as the criteria, the domestic made ELISA reagents sensitivity, specificity, the total coincidence rate and Yoden index of HBsAg, anti-HBc IgM and anti-HAV IgM were evaluated in Hepatitis B pilot surveillance provinces.

RESULTS

In the National Notifiable Diseases Reporting System (NNDRS) reported Hepatitis B cases, the proportion of detecting HBsAg and anti-HBc IgM was 98.53% and 39.49% respectively. Through the verification test to the reported cases in Hepatitis B pilot surveillance provinces, the original and veritication diagnosis 01 the reported eases was quite different. Among 197 acute Hepatitis B reported cases, 56 cases were agreeable with diagnosis cretirea, accounting for 28.42%. Among 1046 chronic Hepatitis B reported cases, the verification diagnosis of 602 cases was consistent with the original diagnosis, accounting for 57.55%. By using Abbott reagent and CMIA method to test again, it was found that the verification test results using domesticmade reagent and ELISA assay were low consistency compared with the test results of Abbott reagent CMIA method. The detection result of home-made reagents by ELISA compared with the Abbott reagents CMIA, the sensitivity and the total coincidence rate of HBsAg were over 95%, Kappa value was 0.439, and specificity was only 50.00%. The sensitivity, the total coincidence rate and the specificity of Anti-HBc IgM were moderate level, Kappa value was 0.516. The sensitivity of Anti-HAV IgM were 20%, and the total coincidence and specificity were higher, Kappa value was 0.033, the consistency of test was poor.

CONCLUSION

It's necessary to improve the detection ability of Hepatitis B etiology of indicators in order to improve the accuracy of the report of Hepatitis B cases.

摘要

目的

评估乙肝试点监测省份实验室中乙肝表面抗原(HBsAg)、乙肝核心抗体 IgM(抗 - HBc IgM)和甲型肝炎抗体 IgM(抗 - HAV IgM)的检测质量。

方法

收集各乙肝试点监测省份的血清以核实检测结果。复检采用美国雅培公司生产的化学发光微粒子免疫分析(CMIA)、ARCHITECT i2000 自动发光检测仪及检测试剂。以雅培试剂 CMIA 检测结果为标准,评估乙肝试点监测省份国产 ELISA 试剂对 HBsAg、抗 - HBc IgM 和抗 - HAV IgM 的敏感性、特异性、总符合率和约登指数。

结果

在国家法定传染病报告系统(NNDRS)报告的乙肝病例中,检测出 HBsAg 和抗 - HBc IgM 的比例分别为 98.53%和 39.49%。通过对乙肝试点监测省份报告病例的核实检测,报告病例的原始诊断与核实诊断差异较大。在 197 例报告的急性乙肝病例中,56 例符合诊断标准,占 28.42%。在 1046 例报告的慢性乙肝病例中,602 例的核实诊断与原始诊断一致,占 57.55%。再次采用雅培试剂和 CMIA 方法检测发现,国产试剂 ELISA 法的核实检测结果与雅培试剂 CMIA 法的检测结果一致性较低。国产 ELISA 试剂检测结果与雅培试剂 CMIA 法相比,HBsAg 的敏感性和总符合率均超过 95%,Kappa 值为 0.439,特异性仅为 50.00%。抗 - HBc IgM 的敏感性、总符合率和特异性处于中等水平,Kappa 值为 0.516。抗 - HAV IgM 的敏感性为 20%,总符合率和特异性较高,Kappa 值为 0.033,检测一致性较差。

结论

有必要提高乙肝病因学指标的检测能力,以提高乙肝病例报告的准确性。

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