血清学检测联合核酸检测在血液中心的应用价值
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摘要
目的探讨在血液中心应用血清学检测联合核酸检测的价值,以提高输血的安全性,降低输血感染风险。方法以我血液中心于2015年1月至2015年12月期间大约共计3000份献血者血液标本作为本组研究的观察对象,所有血液标本均经血清学检测包括HbsAg、HCV抗体、HIV抗原/抗体、梅毒特异性抗体(以下简称酶免),与谷丙转氨酶;并行HBV/HCV/HIV3联检核酸定性检测。对于单纯核酸检测反应性的标本需进行鉴别试验,其中鉴别阴性的献血者进行跟踪检测,并将HbsAg、HCV抗体、HIV抗原/抗体三项酶联免疫检测结果与核酸检测结果进行对比分析。结果本组大约3000份血液标本中,经酶联免疫检测单试剂不合格331份,不合格率为1.35%;其中经酶联免疫检测双试剂反应性且经核酸检测无反应性的不合格标本共31份,其中HbsAg反应性11份,HCV抗体反应性20份;单纯核酸检测反应性标本共43份,经跟踪检测确认其中HBV13例、HIV窗口期感染2例,末检出HCV献血者。结论核酸检测与血清学检测的结果存在一定差别,核酸检测虽然对血清学阴性的HBV感染检出效果明显,但对于感染HBV但病毒载量极低者,其漏检的可能性较高;需要经跟踪检测与实验室检测以进一步确认。
Objective To explore application value of serological detection combined with nucleic acid detection in blood center, to improve safety of blood transfusion, and reduce infection risks. Method Approx. 3000 copies blood samples of blood donors of our blood center from January 2015 to December 2015 were regarded as research objects, all blood samples were tested serologically, including HBs Ag, HCV antibody, HIV antigen/antibody, Treponema pallidum hemagglutination(hereinafter TPHA), and alanine aminotransferase; and carry on HBV/HCV/HIV3 and nucleic acid qualitative detection. For samples of simple reactive nucleic acid detection, carry on identification test, and tracking detection is carried on for negative blood donors, and compare and analyze results of HBs Ag, HCV antibody, HIV antigen / antibody enzyme linked immunosorbent assay and nucleic acid detection. Results Among approx. 3000 copies blood samples, 331 were unqualified by by enzyme linked immunosorbent assay with failure rate of 1.35%; and 31 were unqualified by enzyme linked immunoassay double reagent reactivity and non reactive by nucleic acid detection, among which, 11 were HBs Ag reactive, 20 HCV anti body reactive; 43 simple nucleic acid detection reactive. By tracking and detection, there were 13 cases of HBV, 2 HIV window period infection, no HCV blood donators detected. Conclusion Nucleic acid detection has some differences from serological test results, it has obvious effect for negative serologic HBV infection detection, but has high missing detection possibility for HBV infection and low viral load, which needs to be confirmed by tracking and laboratory detection.
Objective To explore application value of serological detection combined with nucleic acid detection in blood center, to improve safety of blood transfusion, and reduce infection risks. Method Approx. 3000 copies blood samples of blood donors of our blood center from January 2015 to December 2015 were regarded as research objects, all blood samples were tested serologically, including HBs Ag, HCV antibody, HIV antigen/antibody, Treponema pallidum hemagglutination(hereinafter TPHA), and alanine aminotransferase; and carry on HBV/HCV/HIV3 and nucleic acid qualitative detection. For samples of simple reactive nucleic acid detection, carry on identification test, and tracking detection is carried on for negative blood donors, and compare and analyze results of HBs Ag, HCV antibody, HIV antigen / antibody enzyme linked immunosorbent assay and nucleic acid detection. Results Among approx. 3000 copies blood samples, 331 were unqualified by by enzyme linked immunosorbent assay with failure rate of 1.35%; and 31 were unqualified by enzyme linked immunoassay double reagent reactivity and non reactive by nucleic acid detection, among which, 11 were HBs Ag reactive, 20 HCV anti body reactive; 43 simple nucleic acid detection reactive. By tracking and detection, there were 13 cases of HBV, 2 HIV window period infection, no HCV blood donators detected. Conclusion Nucleic acid detection has some differences from serological test results, it has obvious effect for negative serologic HBV infection detection, but has high missing detection possibility for HBV infection and low viral load, which needs to be confirmed by tracking and laboratory detection.
引文
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[2]Raimondo1G,AllainJP,BrunettoMR,etal.StatementsfromtheTaorminaexpertmeetingonocculthepatitisBvirusinfection[J].JHepatol,2008,49(4):652-657.
[3]于志军,邓雪莲,高慧卉,等.血清学检测与核酸检测在献血者血液筛查中的相关性研究[J].实用预防医学,2014,5(21):532-534.
[4]王芳,金钊,栾燕,等.乙型肝炎病毒血液核酸筛查及阳性献血者追踪的研究[J].中国输血杂志,2010,23(2):122-123.
[5]LiuY,LiP,LiCP,etal.DetectionofhepatitisBvirusDNAamongacceptedblooddonorsinNanjing[J].China.VirolJ,2010,7(1):193-198.