血清学联合核酸检测在献血者血液筛查中的互补性  

Correlation between serological assay and nucleic acid testing in screening donated blood for transfusion

作　　者：张锋[1] 张琼[1] 林碧[1] 蔡淑锋[1] 林杰[1] 

机构地区：[1]温州市中心血站,浙江温州325001

出　　处：《中国艾滋病性病》2016年第3期197-199,共3页Chinese Journal of Aids & STD

基　　金：温州市医药卫生科研项目(2015B17)

摘　　要：目的对温州地区无偿献血者的血液标本进行血清学与核酸联合检测,全面评估血清学与核酸检测(NAT)在降低输血相关传染性疾病中的互补性。方法对2014年10月至2015年6月,温州市中心血站采集的无偿献血者的血液标本,用酶联免疫吸附试验(ELISA)对血液传染性指标乙型肝炎病毒表面抗原(HBsAg)、丙型肝炎病毒(HCV)抗体、艾滋病病毒(HIV)抗体、苍白球螺旋体(TP)抗体进行检测,丙氨酸转氨酶(ALT)采用速率法,同时采用核酸检测技术对乙型肝炎病毒(HBV)DNA、HCV RNA、HIV RNA进行6人份三项目联合检测,并对检测结果进行分析。结果 33 736份血液标本中,ELISA(+)NAT(+)95份,其中HBsAg(+)NAT(+)72份,符合率60.5%;HCV抗体(+)NAT(+)13份,符合率11.2%;HIV抗体(+)NAT(+)10份,符合率30.3%。41份ELISA(-)核酸(+)样本,且均为HBV DNA阳性。ELISA(+)NAT(-)173份。ELISA双试剂阳性样本中,HBV、HCV、HIV S/CO≥5的样本组的核酸阳性符合率高于S/CO<5的样本组。结论核酸检测能有效地降低输血传播疾病的发生,但也存在漏检的可能,不能完全取代血清学检测,只有两者有机结合才能真正保证血液的安全。Objective To assess the complementary roles of serological test and nucleic acid test（NAT）in detection of infectious diseases among the blood donors in Wenzhou,so as to ensure the safe blood transfusion.Methods Blood specimens of unpaid donors were collected in Wenzhou blood center from October 2014 to June 2015 to test HBsAg,HCV,HIV,TP by ELISA method,and ALT by rate method.NAT was used simultaneously to screen HBV DNA,HCV RNA,HIV RNA for six doses.Then the results were analyzed.Results Among 33 736 blood samples,there were ELISA（＋）NAT（＋）95samples,including HBsAg（＋）NAT（＋）72with coincidence rate of 60.5%,HCV（＋）NAT（＋）13with coincidence rate of 11.2%,and HIV（＋）NAT（＋）10with coincidence rate of 30.3%.Among 41 samples of ELISA（-）and nucleic acid（＋）,all of the HBV DNA were positive.There were 173 samples of ELISA（＋）NAT（-）.Among the double reagent positive samples tested by ELISA,the coincidence rate of HBV,HCV,HIV S/CO ≥ 5sample group was higher than that of the S/CO〈5groups in NAT（＋）testing.Conclusion NAT detection can effectively reduce the occurrence of transfusion transmitted diseases.However,it cannot completely replace the serological detection and combined use of both methods can ensure the safety of donated blood.

关 键 词：核酸检测 血清学检测 血液筛查 

分 类 号：R512.91[医药卫生—内科学]