血站实验室开展丙氨酸氨基转移酶筛查意义的再次探讨  

The Re-evaluation of the Importance of ALT Testing for Blood Donor Screening

作　　者：刘李栋[1] 孙瑛[1] 朱慧君[1] 顾丽琴[1] 周国平[1] 

机构地区：[1]上海市血液中心,200051

出　　处：《临床输血与检验》2016年第3期224-229,共6页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的通过对丙氨酸氨基转移酶（ALT）检测不合格的献血者在第2次献血时筛查结果的分析，并与合格献血者进行比较，探讨核酸检测模式下血站实验室进行ALT筛查对提高血液安全性的意义。方法对2011年11月～2013年7月上海地区498085例献血者中再次参加献血，且2次献血间隔期在365天以内的单ALT不合格献血者和合格献血者进行分组，比较两组人员在第2次献血时的筛查不合格率；同时，对单ALT不合格献血组中HBV、HCV检测结果不合格的人员进行确认实验并分析结果。结果单ALT不合格献血组的第2次献血筛查结果中ALT不合格率为20．32％，显著高于合格献血组（P〈0．01）：HBV、HCV、HIV和梅毒筛查的不合格率为0．13％、0．20％、0％和0．07％，与合格献血组的差异无统计学意义（P〉0．05）；其HBV、HCV检测不合格人员的确认实验结果均为阴性。在2组ALT不合格人员中未发现HBV、HCV酶联免疫吸附法（ELISA）无反应性而核酸检测反应性的献血者。结论开展核酸检测后，ALT筛查在排查献血者HBV、HCV窗口期感染或HBV隐匿性感染的意义不大，对提高血液安全的效果不明显。Objective To re-evaluate the importance ofalanine aminotransferase （ALT） testing for blood safety improvement after nuclear acid testing performed in Chinese BTSs. Method 498,085 blood donors were collected in Shanghai between November 2011 and July 2013, the donors were divided into two groups, sole ALT disqualified donors and qualified donors with blood donation interval of less than 365 days . The second-time blood screening results of the donors in the two groups and the results of HBV/HCV confirmation testing among sole ALT disqualified donors group were analyzed, Results ALT disqualification rate among the sole ALT disqualified donors was 20.32%, significantly higher than that of qualified group（P〈0.01）. The positive rates of HBV, HCV, HIV and syphilis were 0.13%,0.20%,0%, and 0.07%, respectively, and had no significant difference between the qualified group （P〉0.05）. All HBV/HCV confirmation tests among sole ALT disqualified donors group were negative. Among all ALT disqualified donors within the two groups, no donors of negative HBV or HCV enzyme immunoassay were found to be nueleotide testing positive simultaneously. Conclusion ALT testing, due to the popular implementation of NAT testing, seems to be of no significance in ruling out of HBV and HCV window phase infection as well as HBV latent infection.

关 键 词：丙氨酸氨基转移酶 核酸检测 血液筛查 血液安全 

分 类 号：R457.12[医药卫生—治疗学] R392.11[医药卫生—临床医学]