献血者ALT、HBsAg、HCV—Ab相关性及不同检测模式对血液检测结果的影响  

The correlation of ALT, HbsAg and HCV-Ab and the effect of different detection modes on the resuits in blood donors

作　　者：郑拉让 

机构地区：[1]宝鸡市中心血站,陕西省宝鸡721006

出　　处：《中国医师杂志》2017年第2期267-272,共6页Journal of Chinese Physician

摘　　要：目的分析献血者ALT、HBsAg、丙型肝炎抗体（HCV-Ab）不同检测方法对检测结果的影响，探讨献血者HBsAg、HCV—Ab及ALT分布情况及相关性，ELISA法阴性标本再次核酸检测的检测模式，单试剂HBsAg、HCV-Ab阳性献血者24周（最大窗口期）后再次检测情况，采血前ALT筛查的必要性，为优化血液检测方法提供依据。方法用速率法检测ALT，用ELISA法检测HBsAg、HCV-Ab，对ELISA法检测HBsAg、HCV—Ab阴性血液再次进行核酸检测；街头采血前用干生化仪对献血者进行ALT筛查。结果宝鸡市273316例次无偿献血者总ALT阳性率为4．09％，其中以单项ALT阳性为主（98．17％，11 185／273 316），男性ALT阳性率（5．20％）高于女性（1．79％）（χ2=1780．94，P〈0．05），18～〈45岁ALT阳性率（4．48％）高于45～55岁（3．26％）（χ2=223．87，P〈0．05）；未开展ALT筛查时ALT阳性率（4．90％，8448／172472）高于经ALT筛查后的ALT阳性率（2．71％，2737／100844）（χ2=773．43，P〈0．05）；通过对143815份酶免检测阴性献血者血清再进行核酸检测，未发现HCV-Ab阳性，HBsAg阳性75例；单试剂HBsAg阳性献血者24周后ELISA和核酸复检Kappa值为0．049。结论ALT阳性与HBV、HCV不存在相关性；献血者以ALT单项阳性为主；开展血液ATL筛查、两遍酶免检测一遍核酸检测可提高血液安全水平；HBsAg、HCV-Ab阳性的献血者在24周（最大窗口期）后再进行ELISA及核酸检测阴性者，可回归献血队伍。Objective To investigate the effects of different detection methods on the results for alanine aminotransferase （ALT）, HBsAg and hepatitis C virus antibody （HCV-Ab） through testing the blood of 273 316 person time blood donors from 2009 to June2015, and to investigate the distribution of HBsAg, HCV-Ab and ALT and their correlation in blood donors, detection mode of nucleic acid detection in negative samples used enzyme-linked immunosorbent assay （ ELISA）, the results of blood donors, who were single reagent HBsAg, HCV-Ab positive, were detected again after for 24 weeks （ maximum window period）, and necessity of ALT screening before collecting blood sample, which provided a basis for the optimization of blood detection methods. Methods The rate method was used to detect ALT, detection of HCV-Ab and HBsAg was used ELISA, nucleic acid detection was performed on HBsAg and HCV-Ab negative blood by enzyme immunoassay, and dry chemistry complete automatic biochemistry analyzer were used for ALT screening before blood sampling in street. The enumeration data were analyzed by thex2 test with P 〈0. 05 for statistically significant. Results The total ALT positive rate of 273 316 people was 4. 09% in Baoji cit- y, the single ALT positive was main （98. 17% ,11 185/273 316）. The ALT positive rate （5.20%） of male was higher than that of women （ 1.79% ） （χ2 = 1780.94,P 〈0. 05）, and the ALT positive rate of 18 ～44 years old group （4. 48% ） was higher than that of 45 ～ 55 years old groups （3.26%） （ χ2 = 223.87, P 〈 0. 05）. The positive rate of ALT before earring out ALT screening （4. 90%, 8 448/172 472） was higher than that of after carrying ALT screening （2. 71%, 2 737/100 844） （χ2 = 773.43, P 〈 0. 05）. Through nucleic acid detection for serums of 143 815 ELISA negative blood donors, there were no HCV-Ab positive and 75 HbsAg positive. The Kappa value was 0. 049 between ELISA and nucleic acid examination in single reagent HBsAg positive blood donors after 24 w

关 键 词：供血者 输血 丙氨酸转氨酶/血液 肝炎表面抗原 乙型/血液 肝炎抗体 丙型/ 血液 

分 类 号：R446.6[医药卫生—诊断学]