2015年广州地区无偿献血者核酸和ELISA检测结果分析  

Analyses of Laboratory Detections with PCR and ELISA in Blood Donors of Guangzhou in 2015

作　　者：林诗雅[1] 王淏[1] 李仲平[1] 梁浩坚[1] 谢君谋[1] 肖韶英[1] 郑优荣[1] 

机构地区：[1]广东省广州血液中心,510095

出　　处：《临床输血与检验》2017年第2期137-141,共5页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的分析2015年广州血液中心无偿献血者核酸检测(NAT)和ELISA的筛查结果,探讨NAT和ELISA并行的血液筛查模式下,两种检测方法在降低输血相关病毒感染风险的相关性。方法采用两种ELISA试剂和单人份核酸检测(ID-NAT)平行应用的血液筛查模式,对2015年广州市无偿献血者HBV、HCV和HIV血清学标志物及其病毒核酸进行筛查。核酸初检阳性标本取其血袋血浆进一步做核酸鉴别实验。对HIV-1 RNA鉴别阳性、ELISA阴性的献血者进行追踪随访。结果本中心2015年核酸检测标本合计300 250例,其中初检阳性2 874例,总阳性率0.96%;核酸初检单阳性628例,单阳性率0.21%;鉴别阳性数129例,总阳性率20.58%,鉴别阳性中127例HBV、2例HIV,未发现HCV阳性,其中1例HIV-1 RNA单阳性随访标本送广州市疾控中心经确证为阳性。酶免HBV、HCV和HIV与核酸检测结果比较显示:核酸与酶免HBV、HCV和HIV检测均为阳性共2 204例,2 333例HBV ELISA双试剂阳性标本中78%(1 829/2 333)核酸阳性;343例HCV ELISA双试剂阳性标本中66%(226/343)核酸阳性;92例HIV ELISA双试剂阳性标本中全部为核酸阳性。酶免单试剂阳性标本中6%(57/901)为核酸阳性,94%(844/901)为核酸阴性。酶免双试剂阳性中核酸阳性比例大于酶免单试剂阳性(P<0.05)。结论核酸检测能更进一步缩短输血传播疾病的检测"窗口期",发现隐匿性病毒感染,核酸和酶免检测在降低输血相关病毒感染风险中发挥重要的互补作用。Objective To analyze the results of nucleic acid tests （NATs） and ELISA detections and explore the correlation of them in reducing the risk of transfusion related infections. Methods Using two kinds of ELISA reagents and ID nucleic acid detection （ID-NAT） for parallel blood screening in blood donation to detect serological markers of HBV, HCV and HIV-1 and virus nucleic acids. Samples were taken from blood bags for further identification when primary test was positive. HIV-1 RNA positive ELISA negative blood donors were followed up. Results In total of 300 250 cases, 0.96% （ 2 874/300 250） positive cases were detected in the center in 2015 .The nucleic acid single positive rate was 0.21 % （ 628/300 250） ; the identification positive rate was 20.58% （ 129/628） . 127 HBVand 2 HIV cases were found and no HCV was seen. Enzyme immunoassay of HBV, HCV and HIV and nucleic acid detection results discovered 2 204 positive cases . 78% （ 1 829/2 333 ） HBV ELISA double reagent positive specimens were NAT positive, and 22% （ 504/2 333 ） were NAT negative; 66% （ 226/343 ） HCV ELISA double reagent positive specimens were NAT positive, and 34% （ 117/343） were NAT negative; 92 cases of HIV ELISA double reagent positive samples were all NAT positive. Six percent （ 57/901 ） ELISA single reagent positive were NAT positive, and 94% （ 844/901 ） were NAT negative. The percentage of positive nucleic acid in ELISA double reagent positive was higher than single reagent positive ELISA （P〈0.05 ） . Conclusion NAT helps shorten ＂window period＂ of transfusion transmitted diseases and detect latent infection. Both NAT and ELISA play an important complementary role in reducing the risk of blood transfusion associated virus infection.

关 键 词：核酸扩增检 隐匿性HBV感染 窗口期 无偿献血 

分 类 号：R392.11[医药卫生—免疫学] R193.2[医药卫生—基础医学]