无偿献血者血液标本行核酸检测对降低经血传播HIV的风险评估(1)
[摘要] 目的 探讨无偿献血者血液标本行核酸检测对降低经血传播HIV(人类免疫缺陷病毒)风险的影响。 方法 选取2016年1月～2017年1月无偿献血者血液标本24317份，所有献血者献血前均接受完整健康征询及全面健康体检，所有血液标本均经血液快速检测，酶联免疫吸附测定法(ELISA)与核酸检测。分析ELISA检测与核酸检测结果。 结果 24317份血液标本经血清学两次检测，24107份合格，210份不合格，不合格标本中12份ELISA三项检测均不合格；24107份ELISA检测合格标本经核酸检测出1份HIV-RNA呈阳性，并经生物公司实验证实；ELISA检测不合格标本中，核酸检测57份呈阴性。 结论 核酸检测有助于提高无偿献血者的血液质量，减低经血传播HIV等病毒的风险，保障临床安全用血；同时，临床应加强两种检测方式的联合应用，最大限度的避免病毒感染漏检现象。
[关键词] 核酸检测；人类免疫缺陷病毒；血液标本；风险评估
[中图分类号] R392 [文献标识码] A [文章编号] 2095-0616(2017)10-229-03
Risk evaluation of blood samples from volunteer donors undergoing nucleic acid detection in reducing blood transmission of HIV
HUO Baofeng ZHANG Tianbi LIU Zhimin WEN Fangdan
Shaoguan Central Blood Station，Shaoguan 512026，China
[Abstract] Objective To explore the effect of blood samples from volunteer donors undergoing nucleic acid detection on reducing risk of blood transmission of HIV (human immunodeficiency virus). Methods 24317 blood samples from volunteer donors from January 2016 to January 2017 were selected.All volunteer donors were given complete health consultation and comprehensive physical examination.And all blood samples were all given rapid detection by blood transmission such as enzyme-linked immunosorbent assay (ELISA) and nucleic acid detection. Results Of ELISA and nucleic acid detection were analyzed. Results In 24317 blood samples detected by serology，there were 24107 qualified samples and 210 unqualified samples.In unqualified samples，three detections of ELISA in 12 samples were unqualified.In 24107 qualified samples whose ELISA were qualified，1 sample was with positive HIV-RNA after nucleic acid detection and it was experimentally proved by biological company.In unqualified samples detected by ELISA，nucleic acid detection of 57 samples were negative. Conclusion Nucleic acid detection is helpful to improve blood quality of volunteer donors，reduce risk of blood transmission of HIV and guarantee clinical safety of blood.In addition，combined application of two detections in clinic should be enhanced to maximumly avoid missed detection of virus infection
[Key words] Nucleic acid detection；Human immunodeficiency virus；Blood samples；Risk evaluation
輸血是一种通过静脉经血液输注给患者的治疗方法，目前已广泛应用于临床，且具有无可替代的地位。但受血液安全性影响，输血治疗存在着较大风险，血液质量对治疗效果亦具有显著影响。因此血站工作人员一直将确保血液安全、减小血液传播疾病风险，尤其是HIV感染作为工作质量持续改进的目标[1-2]。临床研究发现，病毒隐匿性、变异性、病毒感染“窗口期”及试剂灵敏度等均在很大程度上影响检测结果[3]。核酸检测技术能够有效检测窗
口期病毒感染、隐匿性与变异性病毒，降低漏检率，从而提高血液安全性。根据国家卫生部门要求，核酸检测已作为无偿献血者血液标本常规检测方法进行病毒感染筛查[4]。本研究在传统血清抗体酶联免疫吸附测定法(ELISA)基础上加用核酸检测，深入分析核酸检测在减低经血传播HIV风险中的应用价值。现报道如下。 (霍宝锋?张天弼?刘智敏?温芳丹)
[关键词] 核酸检测；人类免疫缺陷病毒；血液标本；风险评估
[中图分类号] R392 [文献标识码] A [文章编号] 2095-0616(2017)10-229-03
Risk evaluation of blood samples from volunteer donors undergoing nucleic acid detection in reducing blood transmission of HIV
HUO Baofeng ZHANG Tianbi LIU Zhimin WEN Fangdan
Shaoguan Central Blood Station，Shaoguan 512026，China
[Abstract] Objective To explore the effect of blood samples from volunteer donors undergoing nucleic acid detection on reducing risk of blood transmission of HIV (human immunodeficiency virus). Methods 24317 blood samples from volunteer donors from January 2016 to January 2017 were selected.All volunteer donors were given complete health consultation and comprehensive physical examination.And all blood samples were all given rapid detection by blood transmission such as enzyme-linked immunosorbent assay (ELISA) and nucleic acid detection. Results Of ELISA and nucleic acid detection were analyzed. Results In 24317 blood samples detected by serology，there were 24107 qualified samples and 210 unqualified samples.In unqualified samples，three detections of ELISA in 12 samples were unqualified.In 24107 qualified samples whose ELISA were qualified，1 sample was with positive HIV-RNA after nucleic acid detection and it was experimentally proved by biological company.In unqualified samples detected by ELISA，nucleic acid detection of 57 samples were negative. Conclusion Nucleic acid detection is helpful to improve blood quality of volunteer donors，reduce risk of blood transmission of HIV and guarantee clinical safety of blood.In addition，combined application of two detections in clinic should be enhanced to maximumly avoid missed detection of virus infection
[Key words] Nucleic acid detection；Human immunodeficiency virus；Blood samples；Risk evaluation
輸血是一种通过静脉经血液输注给患者的治疗方法，目前已广泛应用于临床，且具有无可替代的地位。但受血液安全性影响，输血治疗存在着较大风险，血液质量对治疗效果亦具有显著影响。因此血站工作人员一直将确保血液安全、减小血液传播疾病风险，尤其是HIV感染作为工作质量持续改进的目标[1-2]。临床研究发现，病毒隐匿性、变异性、病毒感染“窗口期”及试剂灵敏度等均在很大程度上影响检测结果[3]。核酸检测技术能够有效检测窗
口期病毒感染、隐匿性与变异性病毒，降低漏检率，从而提高血液安全性。根据国家卫生部门要求，核酸检测已作为无偿献血者血液标本常规检测方法进行病毒感染筛查[4]。本研究在传统血清抗体酶联免疫吸附测定法(ELISA)基础上加用核酸检测，深入分析核酸检测在减低经血传播HIV风险中的应用价值。现报道如下。 (霍宝锋?张天弼?刘智敏?温芳丹)