深圳地区HBV核酸检测反应性献血者两种归队模式风险评估研究  

Risk Assessment of Two Regrouped Modes of Reactive Blood Donors with HBV Nucleic Acid Detection in Shenzhen Area

作　　者：杨转笑 肖慧芬 肖忠[2] 邬旭群[3] 方瑛 黄华霖 YANG Zhuanxiao;XIAO Huifen;XIAO Zhong(Longgang Blood Center,Shenzhen,Guangdong,518172,China;不详)

机构地区：[1]深圳市龙岗区中心血站,广东深圳518172 [2]深圳市血液中心,广东深圳518000 [3]深圳市血液中心业务科,广东深圳518000

出　　处：《中国卫生质量管理》2020年第3期111-113,共3页Chinese Health Quality Management

基　　金：2017年深圳市龙岗区经济与科技发展专项资金医疗卫生科技计划项目(201747141)。

摘　　要：目的评估HBV核酸检测反应性献血者归队风险,为采供血机构制定献血者归队策略提供依据。方法对ELISA双试剂无反应性、HBV核酸检测反应性献血者进行跟踪检测。每次间隔3个月以上,两次直接静脉采样。归队后再跟踪两次以上献血检测结果。两家血站分别按无门槛自愿原则与增加献血10次以上要求进行采样,并对两种模式归队结果进行比对。结果无门槛自愿归队模式归队前检测3例酶免检测阴转阳(15.79%);增加献血次数门槛归队模式归队成功率88.46%;两种归队模式成功归队后再次出现不合格情况分别为20.00%、13.04%,统计无差异,但归队后人均年献血次数有较大差别。结论酶免检测无反应性而HBV核酸检测反应性被屏蔽献血者无门槛归队模式存在窗口期感染风险。建议将多次献血或固定献血、首次出现酶免检测无反应性而HBV核酸检测反应性被屏蔽的献血者列入归队目标人群。仅以HBsAg+HBV DNA作为HBV核酸检测反应性献血者的归队评价指标存在较大风险,应考虑增加化学发光法等补充试验。Objective To evaluate the regrouped risk of blood donors in response to HBV nucleic acid testing,and to provide evidence for the establishment of regrouped strategy for blood donors.Methods The blood donors with non-reactive ELISA and reactive HBV nucleic acid detection were followed up and detected.At intervals of more than 3 months,two direct venous samples were taken.After returning to the team,follow up the blood donation test results for more than 2 times.The two blood stations took samples according to the principle of voluntary without threshold and the requirement of increasing blood donation for more than 10 times,and compared the regrouped results between the two modes.Results Three cases(15.79%)were detected before rejoining the team in the mode of voluntary rejoining without threshold.The regrouped success rate of increasing the number of blood donation threshold regrouped mode was 88.46%.There was no statistical difference between the two regrouped modes on disqualified proportion,which were 20.00% and 13.04%,but the number of blood donation per capita per year was significantly different.Conclusion There was a risk of infection in the window period for the non-detection of enzyme without reactivity,while the non-detection of HBV nucleic acid with reactivity of screened blood donors without threshold reentry mode.It was suggested that the blood donors who had donated blood for several times or for a fixed period,who had shown no reactivity of enzyme test for the first time,and whose reactivity of HBV nucleic acid test was shielded should be included in the target group.Only HBsAg+HBV DNA used as the regrouped evaluation index of reactive blood donors for HBV nucleic acid detection had relatively big risk,additional tests such as chemiluminescence should be considered.

关 键 词：献血者归队 核酸检测 乙型肝炎病毒 风险评估 血液质量 无偿献血 

分 类 号：R197.6[医药卫生—卫生事业管理] R446[医药卫生—公共卫生与预防医学]