知识与财富的链接
目的探讨核酸检测技术对基层血站血液安全保障的重要性及存在的问题。方法对2014年7月-2016年7月本站ELISA检测无反应性无偿献血标本进行HIV/HBV/HCV核酸检测,对核酸检测阳性标本进行高精度病毒载量检测和补充血清学试验,部分进行追踪检测,对检测结果进行分析,探讨本地区核酸检出率,及酶免阴性核酸阳性标本感染特征。结果研究阶段内ELISA无反应性标本共43 292份,核酸检测发现HBV DNA阳性标本89例（0.205%）,未发现HCV RNA和HIV RNA阳性标本。对其中75份标本进行HBV DNA高精度病毒载量检测和HBs Ag,抗-HBs,抗-HBe,HBe Ag,抗-HBc ELISA检测,最终确认阳性标本46例,确认阳性率:61.3%。31名追踪献血者中,确定HBV感染25名（80.6%）,其中窗口期4例（16.0%）,一过性感染10例（40.0%）,OBI 11例（44.0%）。结论核酸检测技术能显著提高对经输血传播疾病病毒的筛查水平,与血清学检测手段相互补,可极大降低输血传播疾病残余风险,保障临床用液安全。
Objective To explore the importance and problems of nucleic acid testing technology for blood safety in blood center. Methods Blood donors screened negative by ELISA took NAT of HIV / HBV / HCV from July,2014 to July,2016. The NAT positive samples were tested by high sensitive viral load assay and serological assays. Some donors conducted a follow-up study. Detective data were analyzed to explore the positive rate of NAT and the infective characteristics of ELISA negative samples. Results A total of 43 292 non-reactive samples by ELISA were detected during the study period. Eightynine（ 0. 205%） were found HBV DNA positive by NAT,while none was found HCV RNA nor HIV RNA positive. Forty-five of 75 NAT positive donors were confirmed positive by high sensitive viral load assay and HBs Ag,anti-HBs,anti-HBe,HBe Ag and anti-HBc ELISA assays,and the positive rate was 61. 3%. Out of 31 blood donors who took the follow-up study,25（ 80. 6%） were confirmed with HBV infection,4（ 16. 0%） had window period infection,10 were recovered from the infection（ 40. 0%） and 11（ 44. 0%） were OBI. Conclusion The NAT could improve the screening of transfusion-transmitted virus significantly,and while combined with the serological test,could greatly reduce the residual risk of transfusion-transmitted disease and ensure the safety of clinical blood use.
