抗-HCV反应性献血者淘汰与归队模式的探讨  

A Detection Strategy for Rejection and Rejoin of Blood Donors with Anti-HCV Positive Reactivity

作　　者：刘颖[1] 邓雪莲[1] 周磊[1] 梁晓华[1] LIU Ying;DENG Xue-lian;ZHOU Lei(Dalian Blood Center,Dalian,Liaoning 116001)

机构地区：[1]辽宁省大连市血液中心,116001

出　　处：《临床输血与检验》2018年第1期23-28,共6页Journal of Clinical Transfusion and Laboratory Medicine

基　　金：卫生部医药卫生科技发展研究中心专项课题(No.28-8-3)资助

摘　　要：目的探讨大连地区在常规开展酶免和核酸检测的同时联合电化学作为补充实验,用于抗-HCV反应性献血者的归队方案。方法对2013年1月1日~2015年6月30日大连地区无偿献血的血液筛查结果为抗-HCV反应性的献血者,采用酶免、核酸和电化学联合实验的追踪检测,对回召次数和回召时间间隔的可行性进行探讨。结果期间筛查标本共计192 065份,抗-HCV ELISA反应性献血者679例(0.35%),确定拟跟踪503例(74.1%),成功追踪77例(11.3%),在多次电化学和核酸检测结果都无反应性的前提下,献血后追踪的不同时间间隔及不同次数的酶免阳性率的差异无统计学意义(P=0.106,P=0.353),因此选择假阳性率较低的2次和大于3个月作为暂定的回召次数和首次回召时间间隔。结论在现有的检测模式下,血液筛查的检测技术手段很难避免因试剂、生物学等原因造成假阳性反应的发生,为保护珍贵的献血资源,促进献血队伍的稳定和发展,应进一步深入研究抗-HCV反应性献血者的淘汰与归队模式。Objective This study aimed at investigating the recalling of blood donors in Dalian who had been identified aspositiveanti-HCVcarriers by routine screening methods.Methods Anti-HCV positive samples that had been preliminarily screened by routine screening were re-examined with ELISA,NAT and electro-chemiluminescence assay in Dalian Blood Center from January 2013 to July 2015.The time and intervalof recalling was evaluated.Results A total of 192 065 blood donorswere screened and 679(0.35%)cases wereprimarily identified to beanti-HCV positive.Among them77 cases were followed upby repeated combinative detections stated above.No significant difference of ELISA positive rate between various recalling times and intervals(P=0.106,P=0.353,respectively)was seen in the blood donors whoshowed both negative electro-chemiluminescence assay and NAT.Thus twotimes of recalling and longer than 3 monthsof interval weredeterminedas the appropriate recalling strategy.Conclusion The screen methods routinely usedis insufficient to avoid the occurrence of false positivitiesthat might be related tounqualified regents and/or uncaliberated instruments.A deep approach is needed to optimize thestrategy of laboratory examinations for rejectionof the anti-HCV positive cases or rejoin of qualified blood donors in order toensure the safety of resource.

关 键 词：献血者归队 核酸检测 抗-HCV 

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]