摘要目的 用血清学方法检测乙型肝炎病毒表面大蛋白(HBLP)来筛查隐匿性HBV感染,探讨临床隐匿性HBV感染的血清学检测策略.方法 在日常工作中从临床榆测备份管随机收集2000份用国产ELISA试剂检测HBsAg阴性结果的血清标本,双份分装-20℃冻存,单份标本实施HBLP检测,HBLP阳性标本增加另外两种共三种国产ELISA试剂双份复查HBsAg;HBLP阳性标本再经美国超灵敏MONOLISA HBsAg ULTRA试剂双份检测HBsAg,并行双份DNA定量分析、结果取均值.结果 2000份HBsAg阴性标本共检出15例HBLP阳性:HBLP阳性标本用三种国产ELISA试剂双份复查HBsAg结果一致阴性;通过美国超灵敏MONOLISA HBsAS ULTRA试剂复查HBsAg结果全部阳性;前述15份标本HBV DNA定量分析结果显示均小于500拷贝/ml,其中400～500拷贝/ml 1例,300～400拷贝/ml 3例,200～300拷贝/ml 5例,100～200拷贝/ml 4例,小于100拷贝/ml 2例.结论 用国产常规ELISA试剂检测HBsAg普遍存在漏检,漏检标本HBLP结果可能阳性,检测HBLP有利于筛查出隐匿性H BV感染,为积极寻找临床隐匿性HBV感染的检测策略提供了血清学参考.

abstractsObjective Detecting hepatitis B virus large surface protein (HBLP) with serological method to fdtrate the occult HBV infection and study the clinical detection strategy.Methods Two thousands HBsAg negative stochastic serum samples were collected from the copy tubes in daily work to detect hepatitis B Virus markers (HBVM) with national ELISA regent kits and put them - 20℃ frostily.The 2000 samples were detected with HBLP and filtrated the positive samples.The HBsAg markers were doubly counterchecked with other two adding kinds of national ELISA regent kits (total 3 kinds) at the filtrated samples.The last samples were doubly tested again with American MONOLISA HBsAg ULTRA regents.HBV DNA levels were quantitative analyzed with fluorescence quantitative PCR (FQ-PCR) and taking the mean results.Results Fifteen HBLP positive samples were detected out from the 2000 serum samples.We educed the conform negative results from the three kinds of national regents but conform positive results from the American MONOLISA HBsAg ULTRA regents in repeating HBsAg detection at the 15 samples.The HBV DNA FQ-PCR quantitative results were all less than 500 copies/ml and divided into two cases between 400-500 copies/ml,three cases 300-400 copies/ml,five cases 200-300 copies/ml,four cases 100-200 copies/ml and one case was less than 100copies/ml.Conclusion The false HBsAg negative results for serum samples are more generally through national regents than through importations and HBLP results maybe are positive in these samples.Detecting HBLP marker is propitious to filtrate the occult HBV infection.This study provided a kind of serological reference for actively searching for the detecting strategy in occult HBV infection field.