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目的探讨采用荧光定量聚合酶链反应(FQ-PCR)检测法诊断新生儿乙型肝炎病毒(HBV)感染的经济学成本。方法对2010年3月-2010年7月间202例日龄在28 d以内的新生儿采用酶联免疫吸附法检测HBV血清学标志物,对于HBV血清学标志物中除乙型肝炎表面抗原外其余任何一项或一项以上阳性的新生儿采用FQ-PCR检测其血清HBV-DNA的含量,并分析确诊1例HBV感染病例的费用。结果血清HBV-DNA水平与HBV标志物表现模式有关,乙型肝炎e抗原(HBeAg)阳性的新生儿,FQ-PCR阳性率为3/16(18.8%)。HBeAg阴性之新生儿,FQ-PCR阳性率为1/186(5.4‰)。HBeAg阳性病例为进一步明确乙型肝炎病毒含量而进行FQ-PCR检测所产生的费用为587元/例,HBeAg阴性者为20 460元/例。结论 FQ-PCR确诊HBeAg阳性的新生儿为HBV感染的费用-效益比远高于HBeAg阴性的新生儿,对于HBeAg阴性的新生儿该法不适合大规模的流行病学诊断性研究。
Objective To explore the economic cost of diagnosing neonatal hepatitis B virus (HBV) infection by fluorescent quantitative polymerase chain reaction (FQ-PCR). Methods Between March 2010 and July 2010, 202 HBV serological markers were detected by enzyme-linked immunosorbent assay (ELISA) in 202 newborn infants within 28 days of age. For HBV serological markers except hepatitis B surface antigen The remaining one or more positive newborns using FQ-PCR to detect serum HBV-DNA content, and analyze the diagnosis of a case of HBV infection costs. Results Serum HBV-DNA levels correlated with the pattern of HBV markers. The positive rate of FQ-PCR in HBeAg-positive neonates was 3/16 (18.8%). HBeAg-negative newborns, FQ-PCR positive rate of 1/186 (5.4 ‰). The cost of FQ-PCR testing for HBeAg-positive cases to further confirm the hepatitis B virus content was 587 yuan / case, while HBeAg-negative cases were 20 460 cases / case. Conclusion The cost-benefit ratio of HBV infection confirmed by FQ-PCR in HBeAg-positive newborns is much higher than that in HBeAg-negative newborns. This method is not suitable for large-scale epidemiological studies in HBeAg-negative neonates.