福州地区无偿献血者HBV感染检出情况分析  

Analysis of detectability of HBV among voluntary blood donors in Fuzhou

作　　者：赵亮[1] 周晓真[1] 涂东晋[1] 林洪铿[1] 

机构地区：[1]福建省血液中心,福州350004

出　　处：《福建医药杂志》2017年第2期69-73,共5页Fujian Medical Journal

基　　金：福建省卫生厅青年科研课题项目(2012-1-13)

摘　　要：目的了解福州地区无偿献血者的血液标本在1遍ELISA结合1遍核酸扩增技术(NAT)的血液筛查模式下,HBV感染的检出情况。方法采用HBsAg ELISA试剂和美国诺华Procleix Ultrio Assay系统对福州地区2014全年的86 183份无偿献血者血液标本进行筛查,结合HBsAg中和确证试验排除HBsAg ELISA检测的假阳性标本,分析HBV感染检出情况以及经HBsAg ELISA筛查后标本中残存HBV DNA的阳性率。对检出的HBsAg(-)/HBV DNA(+)标本按献血者的性别、年龄和是否重复献血进行分组比较,并对其中部分标本进行HBV相关血清标志物的检测。结果 HBsAg ELISA检出HBV感染标本800份,经中和确证后HBsAg(+)标本合计700份,检出率0.812%,其中有175份HBsAg经确证阳性的标本,NAT结果为无反应性。本研究中共检出62份HBsAg(-)/HBV DNA(+)标本,HBsAg(-)标本中HBV DNA(+)的检出率为0.073%。HBsAg(-)/HBV DNA(+)在>40岁年龄组的检出率高于<25岁和25~40岁年龄组,不同性别和是否重复献血者组间检出率差异均无统计学意义。对48份HBsAg(-)/HBV DNA(+)标本HBV血清标志物补充试验发现,2份标本HBV相关血清标志物全阴,40份标本HBcAb阳性伴或不伴有HBsAb阳性,检出率高达83.3%。结论 NAT虽然不能完全替代目前的血清学检测,但是作为一种有效的补充检测手段,与ELISA结合检测,能够有效降低由于窗口期和隐匿性乙型肝炎感染(OBI)引起的输血传播HBV的风险,提升血液安全。Objective To find out the detectability of HBV among voluntary blood donors when the blood sample was under the screening model of once-ELISA combined with once-NAT. Methods We used HBsAg ELISA detection kit and the Procleix Ultrio Assay system of NVS to screen 86 183 blood samples from voluntary blood donors in Fuzhou, 2014; combined HBsAg confirmatory test to eliminate the false positive samples which were detected by HBsAg ELISA; analyzed the detectability of HBV and the percentage of HBV DNA after the detection of HBsAg ELISA grouped and analyzed the detected HBsAg （-） /HBV DNA （＋） samples according to the donors＇ gender, age and the situation of repeated donation and tested some samples for the HBV related serological markers. Results HBsAg ELISA detected 800 samples which were infected with HBV. After the HBsAg confirmatory test, 700 samples were HBsAg （q-）, the detection rate was 0. 812%, among which 175 samples were NAT non-reactive while they were positive in HBsAg test. Sixty-two samples were detected as HBsAg （-） /HBV DNA （ ＋ ） in total and the detection rate of HBV DNA was 0. 073 %. The detectability of HBsAg （ - ） /HBV DNA （＋） in the over- 40 age group was higher than that in both under-20 age group and 25-40 age group. There was no difference showed in detect- ability when it came to gender and repetition of donation. When we tested the HBV related serological markers of the 48 HBsAg （-） /HBV DNA （＋） samples, 2 of them were all negative in the HBV related serological markers and 40 of them were HBcAb positive with or without HBsAb positive. The detectability was as high as 83.3 %. Conclusion Although NAT cannot fully replace the current serological test, but as an effective additional test, combining ELISA, it can effectively reduce the risk of HBV caused by window phase and OBI. Hence the blood safety will be increased.

关 键 词：血液筛查 无偿献血 乙型肝炎病毒 核酸检测 

分 类 号：R446.6[医药卫生—诊断学] R512.62[医药卫生—临床医学]