乙肝表面抗原阴性而核酸阳性献血者血液的安全性评估  

Blood safety of HBsAg negative and nucleic acid positive blood donors

作　　者：周豪杰[1] 李然[1] 游冉冉[1] 黎美娜[2] 

机构地区：[1]广州血液中心质量控制部,广东广州510095 [2]广州血液中心血源管理部

出　　处：《包头医学院学报》2017年第7期4-5,21,共3页Journal of Baotou Medical College

基　　金：广州市医药卫生科技项目(20151A011062)

摘　　要：目的:探讨筛查时乙肝表面抗原阴性而核酸阳性献血者血液的安全性。方法:对107名筛查时定性检测乙肝表面抗原阴性而核酸阳性献血者进行乙肝两对半定量检测和HBV-DNA定量检测。结果:29例(27.11%)献血者HBV-DNA定量检测为阳性,均为HBV隐匿性感染;78例(72.89%)献血者HBV-DNA定量检测为阴性。HBV-DNA(+)组的HBc Ab阳性率(55.17%)高于HBV-DNA(-)组(32.05%)(P<0.05);两组间的其余HBV血清学标志物阳性率及标志物定量差别无统计学意义(P>0.05)。HBV-DNA(+)组共出现7种血清学组合模式,以"全阴性"、"45"、"2"和"5"为主,占86.21%。HBV-DNA(-)组共出现10种血清学组合模式,全阴性27例(34.62%),任一HBV血清学标志物阳性共51例(65.38%);HBsAb(+)共31例(39.74%),其HBsAb均≥10 IU/m L,并且有11例HBsAb≥100 IU/m L,血清学模式包括单独"2"模式23例(29.49%),"245"和"25"模式共7例(8.98%),以及"12"模式1例(1.28%)。结论:筛查时定性检测乙肝表面抗原阴性而核酸阳性献血者定量检测结果为HBV-DNA(+)组具有HBV传染性,结果为HBV-DNA(-)、血清学标志物全阴性以及免疫保护模式可认为不具有HBV传染性。Objective：To investigate blood safety of Hepatitis B surface antigen （HBsAg） positive and nucleic acid negative blood donors. Methods： A total of 107 blood donors who were HBsAg negative and nucleic acid positive were quantified for HBV - DNA and five serological markers of HBV. Results： 29 blood donors （27.11% ） were positive for HBV - DNA and had occult HBV infection, in which 7 serological mod- els were found and models ＂ - ＂ , ＂45＂ , ＂2＂ , ＂5＂ were predominant（86.21% ）. 78 blood donors （72.89 % ） were negative for HBV - DNA and lO serological models were found, in which 27 blood donors （34.62 % ） were negative for all serological markers of HBV and 51 blood donors （ 65.38 % ） were positive for any one. 31 blood donors （39.74 % ） were positive for HBsAb in the HBV - DNA（ - ） group and their HBsAb were all I〉 l0 IU/mL, in which model ＂2＂ was 29.49 % （23/78） , models ＂245＂ and ＂25＂ were 8.98 % （7/78）, and model ＂ 12＂ was 1.28 % （1/ 78）. The positive rate of HBcAe in HBV - DNA（ ＋ ） group was significantly higher than that in HBV - DNA（ - ） group （ P 〈 0.05 ）. Conclu- sion ： Blood donors who are HBsAg negative and nucleic acid positive are HBV - DNA positive and have HBV infection while blood donors who arc negative for HBV markers and in immune protection models have no HBV infection.

关 键 词：乙肝表面抗原 核酸检测 血液安全 

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