惠州市假反应性无偿献血者归队检测策略探讨  

Discussion on Re-entry Detective Strategy for Unpaid Blood Donors with False-reactive Results in Huizhou

作　　者：李雪群 严凤好[2] 钟展华 万小春[2] 蓝建崇[2] 李康生[1] 

机构地区：[1]汕头大学医学院微生物与免疫学教研室,516003 [2]惠州市中心血站

出　　处：《临床输血与检验》2017年第2期194-197,共4页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的通过对假反应性献血者的追踪检测,探讨灰区保留意义以及适用于基层血站的归队检测策略。方法选取2014年1月~2016年2月单试剂反应(含灰区)无偿献血标本712例,按ELISA检测结果把标本分成灰区组及单试剂反应组。经过6个月以上的屏蔽期,对召回的献血者标本进行ELISA双试剂检测,NAT单检及确证试验确认。结果初次ELISA检测中,经NAT(或TPPA)确认后,HBsAg、抗-T P的灰区组与单试剂反应组之间假反应率的差异有统计学意义(P<0.05);而抗-HCV在两组间假反应率的差异无统计学意义。经过6个月以上屏蔽期的拟归队检测中,灰区组213例中的1例NAT反应但不被确证试验证实,单试剂反应组268例中的3例NAT反应性且确证试验阳性。结论在当前普遍开展核酸检测的检测模式下,仍保留灰区设置,致使假反应性标本比例增高,导致血液浪费。Objective To investigate the sense of keeping the border area, find the re-entry detective strategy, follow-up detection were used to check the blood donors with false-reactive results in basic-level blood station. Methods during January 2014 to February 2016, 712 cases which reacted in single reagent （including border area） were selected. Based on ELISA test results, specimens were divided into border area group and single-reagent-reactive group. After more than six months of shielding, re-entry specimens were tested by ELISA in double reagent, nucleic acid testing （NAT） and confirmatory test. Results In the first ELISA test, the result were confirmed by NAT（or TPPA） , the difference of the false- reactive rate of HBsAg and anti-TP in the border area group and single-reagent-reactive group was statistically significant,P 〈 0.05.While the difference of anti-HCV false-reactive rate between the two groups has no statistical significance. After more than six months of shielding, the re-entry test showed that, 1 of 213 in the border area group was reactive in NAT, but not confirmed by the confirmatory test, 3 of the 268 in the single-reagent-reactive group were confirmed by NAT and confirmatory test. Conclusion Since NAT was carried out broadly under the present detection mode, if keep on setting border area, it will increase the false-reactive specimens, may result in blood waste.

关 键 词：假反应性 无偿献血者 归队 核酸检测 

分 类 号：R193.2[医药卫生—卫生事业管理] R392.11[医药卫生—公共卫生与预防医学]