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目的:比较不同样本中HBV抗原的检出率,探讨唾液传播在HBV传播流行中的意义。方法:采集上海市第六人民医院和徐汇区大华医院口腔科就诊患者唾液标本891份,平行采集带血唾液578份和血清标本450份,用酶联免疫吸附法(ELISA)进行乙肝五项检测,使用SPSS19.0软件包对数据进行χ2检验。结果:普通唾液、血性唾液、血清3类样本的性别、年龄和户籍差异均无统计学意义(P>0.05),分别检出8种、11种、12种HBV-M组合模式。普通唾液标本中检测出6个“大三阳”(0.67%),检出率与血性唾液标本(0.87%)、血清标本(1.56%)相当(P>0.05)。血清标本的HBs Ag检出率显著高于血性唾液和普通唾液(P<0.001),普通唾液与血性唾液的检出率无显著差异(P>0.05),且血清样本男性组和女性组、不同年龄组、外地组和本地组的HBs Ag阳性率均无显著差异(P>0.05),3类标本中HBe Ag阳性率的差异无显著性。结论:唾液是乙肝传播的重要途径之一。当传染性比较强时,唾液标本中的病毒含量较高。唾液中乙肝病毒可能来源于血液之外的其他途径。
Objective: To compare the detection rate of HBV antigens in different samples and to explore the significance of salivary transmission in the spread of HBV. Methods: 891 salivary samples from patients in Department of Stomatology, Shanghai Sixth People’s Hospital and Dahua Hospital of Xuhui District were collected. 578 blood saliva samples and 450 serum samples were collected in parallel. Five items of hepatitis B were detected by enzyme linked immunosorbent assay (ELISA) Testing, using SPSS19.0 software package χ2 test data. Results: There was no significant difference in gender, age and family register among the three types of saliva, bloody saliva and serum (P> 0.05). Eight, eleven and twelve HBV-M combinations were detected. Six saliva samples (0.67%) were detected in common salivary samples. The detection rate was comparable to that of bloody saliva samples (0.87%) and serum samples (1.56%) (P> 0.05). The detection rate of HBs Ag in serum samples was significantly higher than that in bloody saliva and normal saliva (P <0.001), but no significant difference was found between common saliva and bloody saliva (P> 0.05). Serum samples were different between men and women There was no significant difference in the positive rate of HBs Ag between the age group, the field group and the local group (P> 0.05). There was no significant difference in the positive rate of HBe Ag between the three groups. Conclusion: Saliva is one of the important ways of hepatitis B transmission. When the infectivity is high, the virus content in saliva specimens is high. Hepatitis B virus in saliva may come from other ways than blood.