核酸检测在血液传染病筛查的应用价值  

Application value of nucleic acid detection in screening blood infectious diseases

作　　者：李广波 轩乾坤 羽晓瑜[1] 温冬华 杨思敏 LI Guangbo;XUAN Qiankun;YU Xiaoyu;WEN Donghua;YANG Simin(Department of Clinical Laboratory,Affiliated East Hospital,School of Medicine,Tongji University,Shanghai 200123,China)

机构地区：[1]同济大学附属东方医院检验科,上海200123

出　　处：《重庆医学》2021年第12期2034-2037,共4页Chongqing medicine

基　　金：上海市公共卫生体系建设三年行动计划(2020-2022年)项目(GWV-10.1-XK04)。

摘　　要：目的探讨核酸检测在血液传染病筛查[乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)、人类免疫缺陷病毒(HIV)]的应用价值。方法选取2018-2019年在该院住院因手术或输血需要检测乙肝五项和抗HCV、HIV抗原抗体的500例患者血清标本。化学发光法检测乙肝五项、抗HCV、HIV抗原抗体,提取核酸定性检测HBV DNA、HCV RNA、HIV RNA。比较两种方法的检测结果,不一致的标本检测病毒载量确认最终结果。结果检测出11例HBV化学发光与核酸定性结果不一致标本,未检出HCV和HIV化学发光与核酸定性结果不一致标本。2例HBsAg阳性HBV DNA定性阴性检测标本检测载量均小于20 IU/mL。9例HBsAg阴性HBV DNA定性阳性样品中2例未检测到HBV DNA载量,6例标本检测到HBV DNA载量小于20 IU/mL,1例标本HBV DNA载量为23.6 IU/mL。结论HBV、HCV、HIV病原体核酸检测有利于检测出窗口期和免疫状态异常的感染者。Objective To investigate the application value of nucleic acid detection in screening blood infectious diseases(HBV,HCV and HIV).Methods A total of 500 serum samples needing to detect hepatitis B 5 items,ant-HCV and HIV antigen and antibody due to hospitalization surgery or blood transfusion in this hospital during 2018-2019 were collected.The chemiluminescence method was used to detect the hepatitis B 5 items,anti-HCV,HIV antigen and antibody.The nucleic acid was extracted to qualitatively detect HBV DNA,HCV RNA and HIV RNA.The detection results were compared between the two methods.The viral load in the samples of inconsistent results was detected for confirming the final results.Results Eleven samples of HBV inconsistent results by chemiluminescence and nucleic acid qualitative methods were detected.There was no samples with inconsistent results of HCV and HIV detected by the chemiluminescence and nucleic acid qualitative methods.The loads detected in 2 samples of HBsAg positive and HBV DNA qualitative negative were all less than 20 IU/mL.Among 9 samples of HBsAg negative HBV DNA qualitative positive,HBV DNA load was not detected in 2 samples.The detected HBV DNA load was less than 20 IU/mL in 6 samples.The HBV DNA load in 1 sample was 23.6 IU/mL.Conclusion The pathogen nucleic acid detection of HBV,HCV and HIV is conducive to detect the infected persons with window period and immune state abnormality.

关 键 词：血液传染病核酸筛查 乙型肝炎 HCV RNA检测 HIV RNA检测 

分 类 号：R446.9[医药卫生—诊断学]