输血前患者传染病检测为弱阳性结果的准确性探讨  

Discussion on the accuracy of weak positive results of infectious disease detection in patients before blood transfusion

作　　者：王伟[1] 袁君 李娜[1] 黄雪莲 范许洲[1] 栾建凤[1] WANG Wei;YUAN Jun;LI Na;HUANG Xue-lian;FAN Xu-zhou;LUAN Jian-feng(Department of Blood Transfusion Medicine,General Hospital of Eastern Theater Command,PLA,Nanjing 210002,Jiangsu,China)

机构地区：[1]东部战区总医院(原南京军区南京总医院)输血医学科,南京210002

出　　处：《东南国防医药》2021年第5期471-474,共4页Military Medical Journal of Southeast China

基　　金：全军重大课题(ANJ13J001)。

摘　　要：目的探讨酶联免疫吸附试验(ELISA)检测输血前患者传染病四项(HBsAg、抗-HCV、抗-TP、抗-HIV)为弱阳性结果的准确性。方法对东部战区总医院输血医学科142份传染病四项弱阳性标本,分别用中和实验对HBsAg和免疫印迹实验对抗-HCV、抗-HIV、抗-TP进行确证检测,并回顾性跟踪统计一段时间内166例初次检测为弱反应性患者的ELISA复查结果。结果传染病四项标本ELISA方法检测的样本值与临界值(Sample/cut off,S/CO)的比值在1.0~3.0之间,其阴性率分别为41.67%、93.33%、85.71%、20.00%;S/CO值在3.0~5.0之间,其阴性率分别为13.33%、83.33%、100.00%、0.00%;S/CO值5.0~7.0以上,其阴性率分别为8.33%、75.00%、100.00%、0.00%。166例为弱反应性的标本用ELISA复查后,传染病四项转阴率分别为11.62%、55.56%、100.00%、16.67%。结论传染病四项检测结果为弱阳存在很大比例假阳性率,且随着S/CO值的增高,假阳性比例逐渐减少且跟踪复查患者的转阴率也明显下降。Objective To investigate the accuracy of the results of weak-positive specimens of infectious disease test(HBsAg,anti-HCV,anti-TP,anti-HIV)in patients before blood transfusion.Methods A total of 142 weak-positive specimens of four tests for infectious diseases in the Blood Transfusion Department of the Eastern Theater General Hospital were investigated by neutralizing experiments with HBsAg and western blotting with anti-HCV,anti-HIV and anti-TP,and retrospectively count the ELISA test results of 166 cases of weakly reactive patients tested for the first time in a period of time.Results The ELISA assay for specimens of four tests for infectious diseases detected S/CO values between 1.0 and 3.0,and the negative rates were 41.67%,93.33%,85.71%,20%,respectively.The S/CO value was between 3.0 and 5.0,and the negative rates were 13.33%,83.33%,100.00%,0.00%,respectively.And the S/CO values were 5.0-7.0,the negative rates were 8.33%,75.00%,100.00%,and 0%,respectively.The negative conversion rates of 166 cases followed up for review were 11.62%,55.56%,100.00%,and 16.67%,respectively.Conclusion The results of four tests for infectious diseases have a large proportion of false positives in weak-positive,and with the increase of S/CO value,the proportion of false positives gradually decreases and the rate of negative conversion of patients who follow the review is also significantly decreased.

关 键 词：传染病四项 中和试验 免疫印迹法 弱反应性 复查 

分 类 号：R446.5[医药卫生—诊断学]