重庆地区近2年血液核酸集中化检测结果分析  

Result analysis of nucleic acid testing on blood samples in the Chongqing region with a macroscale collection-and-test detection model

作　　者：谢晓艳 王露楠 张巧琳[1] 尹丹[1] 毕蕾静 魏兰[1] 李维[1] XIE Xiaoyan;WANG Lunan;ZHANG Qiaolin;YIN Dan;BI Leijing;WEI Lan;LI Wei(Chongqing Blood Center, Chongqing 400015, China;National Center for Clinical Laboratories.)

机构地区：[1]重庆市血液中心,重庆400015 [2]国家卫生计生委临床检验中心

出　　处：《中国输血杂志》2018年第2期117-120,共4页Chinese Journal of Blood Transfusion

摘　　要：目的探讨重庆地区血液核酸集中化检测的意义。方法对2016年1月—2017年6月,本市血液中心及重庆区县14家血站/库的血液标本,采用核酸检测试剂与酶联免疫法（ELISA）试剂平行检测。对联检反应性标本进行鉴别试验。对重庆市血液中心及区县血站/库的的核酸检测的联检反应性率、单反应性率、鉴别率进行分析,并对疑似HIV＂窗口期＂献血者做追踪和随访。结果共检测中心标本20 9328例,区县标本11 0588例。中心联检反应性率、单反应性率、鉴别反应性率分别为0.72%（1497/20 9328）、0.34%（707/20 9328）、30.98%（219/707）,区县分别为1.1%（1228/11 0588）、0.61%（671/11 0588）、36.81%（247/671）。对核酸联检单反应性的标本做鉴别试验,共检出HBV反应性标本中心212例,区县血站/库246例;HIV反应性：中心检出3例,区县血站/库检出1例,并对这4例献血者进行了追踪随访,3例转阳确证为HIV＂窗口期＂。而HCV均未被检出。结论重庆市血液中心及辖区内各区县核酸检测结果存在区域性差异。核酸检测敏感性高,可检测出标本中及其微量的核酸,显著缩短病毒＂窗口期＂,有效降低了经血传播传染病的危险。Objcective To investigate the impact of nucleic acid testing（ NAT） through systematic retrospective analysis on the nucleic acid test screening data of blood in Chongqing with a macroscale collection-and-test detection model. Methods Data from 1 city blood center and 14 district/county centers were collected and compared. All of the samples were analyzed by NAT and Enzyme-Linked Immuno Sorbent Assay（ ELISA） in a parallel test setup. Moreover,nucleic acid identification test was conducted to identify NAT-positive samples. We analyzed the combined reaction rate、the NAT single reactive rate,the identification detection rate from data during the period between Jan,2016 to Jun,2017. We also followed up the HIVsuspected ＂window period＂blood donors. Results A total of 20 9328 samples from Chongqing city Blood Center and 110588 samples from the other 14 blood stations were tested by NAT. The combined reaction rate,the NAT single reactive rate,the identification detection rate were 0. 72%（ 1497/20 9328） 、0. 34%（ 707/20 9328） 、30. 98%（ 219/707） in the Chongqing city Blood Center,respectively. These rates from the other 14 centers were 1. 1%（ 1228/11 0588）,0. 61%（ 671/11 0588）,36. 81%（ 247/671）,respectively. The nucleic acid identification test showed 212 HBV-DNA-reactive samples,3 HIV-reactive samples,0 HCV-reactive sample from Chongqing city Blood Center and 246 HBV-DNA-reactive samples,1 HIV-reactive sample,0 HCV-reactive sample from the other 14 blood stations. 4 reactive cases in the nucleic acid detection test were followed up,and 3 of them were confirmed as HIV＂ window period＂. There were regional differences in the rate of NAT single reactive and the rate of identification reactive analyzing the district/county data. Conclusion There are regional differences in the detection results in the districts and counties of Chongqing. Nucleic acid amplification technology presents high sensitivity and is capable of detecting the nucleic acid in the specimen and thus significantly

关 键 词：血液集中化检测 区域性差异 血液安全 

分 类 号：R446.11[医药卫生—诊断学] Q503[医药卫生—临床医学]