ISSN 2097-5724 CN 61-1535/R 主管·主办:陕西省疾病预防控制中心
疾病预防与控制 Disease Prevention and Control 医学学术期刊 双月刊
2025-06-069 检验与方法 2025, 1(06): 133-136

慢性乙肝患者采用乙肝两对半和HBV-DNA联合检验的诊断价值

广州市从化区中医医院

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摘要

目的 系统评价乙肝两对半与乙型肝炎病毒脱氧核糖核酸(HBV-DNA)联合检测在慢性乙型肝炎(CHB)患者诊断中的临床应用价值。方法 病例样本的筛选节点处于2023年7月至2024年7月,从本院选定96例慢性乙肝患者作为调研对象,所有患者均施以乙肝两对半+HBV-DNA检验,最后收集、整理检测结果,用于联合检验方法应用价值的客观评价。结果 乙肝两对半检测显示大三阳28例(29.17%),小三阳36例(37.50%);HBV-DNA检测显示大三阳和小三阳患者的病毒载量[分别为(2.16±0.18)×107 IU/mL和(1.99±0.27)×107 IU/mL]显著高于其他模式患者(P<0.05),但两组间病毒载量差异无统计学意义(P>0.05)。以HBV-DNA阳性为金标准,大三阳和小三阳的灵敏度均为41.82%,特异度分别为87.80%和68.29%。结论 乙肝两对半与HBV-DNA联合检测可优势互补,显著提高CHB的诊断准确率,降低漏诊风险,优化临床诊疗路径,具有重要的推广应用价值。

Abstract

Objective To systematically evaluate the clinical utility of combined hepatitis B five markers with hepatitis B Virus Deoxyribonucleic acid(HBV-DNA) testing in the diagnosis of chronic hepatitis B(CHB). Methods From July 2023 to July 2024, a total of 96 chronic hepatitis B patients from our hospital were enrolled as research subjects. All patients underwent testing for Hepatitis B five markers and HBV-DNA assays. The results were systematically analyzed to evaluate the clinical utility of this combined diagnostic approach. Results Among the patients, 28(29.2%) were HBeAg-positive and 36(37.5%) were HBeAg-negative. Both the HBeAg-positive group [(2.16±0.18) ×107 IU/mL] and the HBeAg-negative group [(1.99±0.27) ×107 IU/mL] groups showed significantly higher HBV-DNA levels compared with other serological patterns(P<0.05), although no significant difference was found between the two groups(P>0.05). Using HBV-DNA positivity as the reference, the sensitivity for detecting HBeAg-positive and HBeAg-negative patterns was 41.82%, with specificities of 87.80% and 68.29%, respectively. Conclusion Combining Hepatitis B five markers with HBVDNA testing enhances diagnostic accuracy for CHB, reduces missed diagnoses, and provides a valuable approach for optimizing clinical decision-making.

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[1]利仲权.慢性乙肝患者采用乙肝两对半和HBV-DNA联合检验的诊断价值[J].疾病预防与控制,2025,1(06):133-136.