无偿献血者ALT水平异常与HBI,OBI,HCI和OCI的相关性研究  

Investigating the Correlation of Abnormal ALT Level and HBI, OBI, HCI, OCI in Volunteer Blood Donors

作　　者：郭燕[1] 贺晨[1] 段勇[1] 现红斌 张欢 李锦[1] GUO Yan;HE Chen;DUAN Yong;XIAN Hong-bin;ZHANG Huan;LI Jin(Shaanxi Blood Center,Xi’an 710061,China)

机构地区：[1]陕西省血液中心,西安710061

出　　处：《现代检验医学杂志》2020年第2期18-21,共4页Journal of Modern Laboratory Medicine

基　　金：陕西省自然科学基础研究计划(2015JM8393)。

摘　　要：目的探讨无偿献血人群丙氨酸氨基转移酶(alanine aminotransferase,ALT)水平异常与乙型肝炎病毒感染(hepatitis B virus infection,HBI),隐匿性乙型肝炎病毒感染(occult hepatitis B virus infection,OBI),丙型肝炎病毒感染(hepatitis C virus infection,HCI),隐匿性丙型肝炎病毒感染(occult hepatitis C virus infection,OCI)的相关性。方法分析陕西省血液中心2019年1~6月98 697份血液标本ALT,HBV,HCV检测结果;对其中ALT单项异常标本进行核酸检测(nucleic acid testing,NAT)。此外,收集ALT初筛不合格血样125份,合格血样112份,实验室检测ALT,HBsAg和抗-HCV,分离外周血淋巴细胞(peripheral blood mononuclear cells,PBMCs)并检测HCV RNA。结果 98 697份血液标本中ALT水平异常者654份,其中ALT单项异常者641份,ALT合并HBsAg/抗-HCV阳性8份,仅占ALT异常者的1.22%;HBsAg阳性组,抗-HCV阳性组与对应阴性组的ALT异常率差异无统计学意义(P> 0.05);ALT初筛不合格者HBV,HCV感染率高于ALT初筛合格者(4.8%vs 0.86%)和ALT复检不合格者(4.8%vs 1.22%),差异有统计学意义(χ~2=22.78,7.61,均P <0.05);641份ALT单项异常者NAT检测发现HBV DNA阳性一例;ALT初筛不合格血样中的119例ALT单项异常者检出OCI一例,112例合格献血者未检出OCI。结论 ALT筛查献血者OBI,HBI,HCI及窗口期的意义并不大,ALT对OCI筛查有一定意义。Objective To discuss the correlation of abnormal ALT level and hepatitis B virus infection(HBI), occult hepatitis B virusinfection(OBI), hepatitis C virus infection(HCI) and occult hepatitis C virusinfection(OCI) in volunteer blood donors. Methods The blood screening results of ALT, HBV and HCV of 98 697 blood donors from January to June 2019 were analyzed.NAT was conducted on ALT single unqualified donors. 125 and 112 samples that had abnormal and normal ALT level in preliminary screening were collected, ALT, HBsAg and anti-HCV were detected, peripheral blood mononuclear cells(PBMCs) were extracted and HCV RNA were detected. Results Among 98 697 donors, 654 were ALT abnormal, 641 were ALT single abnormal and 8(1.22%) were found to have unqulified results with both ALT and HBV/HCV markers.No statistically differences was found between hepatitis markers positive and negative groups(P>0.05). The positive rate of HBV/HCV was higher in ALT unqualified donors than qualified donors in ALT preliminary screening(4.8% vs 0.86%), and which was higher than the donors who were ALT unqualified in second test either(1.22%), the differences were statistically significant(χ~2=22.78,7.61,all P< 0.05).one HBV DNA was detected in 641 ALT single abnormal donors, one OCI was detected in 119 ALT single abnormal blood donors and none was in 112 eligible blood donors. Conclusion It is meaningless to screen OBI, HBI or HCI and their window periods through ALT, but ALT screening is helpful to eliminate OCI.

关 键 词：无偿献血者 丙氨酸氨基转移酶 乙型肝炎病毒感染 丙型肝炎病毒感染 隐匿性乙型肝炎病毒感染 隐匿性丙型肝炎病毒感染 

分 类 号：R457.12[医药卫生—治疗学]