CMIA法在输血前感染性指标检测中的应用研究

Application of CMIA Method in the Detection of Infection Indicators Before Blood Transfusion

目的对化学发光微粒子免疫测定(CMIA)技术定量检测输血前感染性指标的临床应用进行评价。方法用CMIA技术对22235例患者进行输血前乙肝表面抗原(HBsAg)、抗丙型肝炎病毒抗体(Anti-HCV)、抗梅毒螺旋体特异性抗体(Anti-TP)及抗人类免疫缺陷病毒抗体(Anti-HIV)定量检测,所有阳性标本用相应的酶联免疫吸附法(ELISA)进行定性检测,Anti-TP阳性标本用梅毒螺旋体抗体明胶颗粒凝集试验(TPPA)进行确诊,Anti-HIV阳性标本送市疾控中心进行抗体确认,并对几种方法的检测结果进行分析。结果 HBsAg、Anti-HCV、Anti-TP、Anti-HIV定量检测阳性例数分别为3028、336、684、63;定量阳性标本经ELISA检测,定性阳性例数分别为2472,269,668,58;684例Anti-TP定量阳性样本中,用TPPA确认,阳性603例;63例Anti-HIV定量阳性样本送南充市疾控中心进行确认,48例确定为阳性,5例不确定,10例为阴性。结论 CMIA法定量检测输血前感染性指标可及早发现感染"窗口期"患者,降低漏检率,有利于患者的早期诊断和治疗,有利于医护人员自我防护及减少医疗纠纷。

Objective To evaluate the application of chemiluminescent microparticle immunoassay （CMIA） technology in quantitative detection of pre-transfusion infection indicators. Methods The pre-transfusion serum levels of hepatitis B surface antigen （ HBsAg）, hepatitis C virus antibody （ anti- HCV）, anti- Treponema palli- dumspecific antibody （ Anti- TP） and anti- humanimmunodeficiency virus antibody （ anti- HIV ） in 22,235 cases of patients were determined with chemiluminescent microparticle immunoassay （CMIA）. The qualitative detection of all positive samples were carried out by the corresponding enzyme-linked immunosorbent assay （ELISA）, and the anti-treponema pallidum antibody （Anti-TP） positive samples were confirmed by Trepone- ma pallidum antibodies gelatin particle agglutination test （TPPA）. Results The number of positive cases of HB- sAg, Anti-HCV, Anti-TP and Anti-HIV in 22,235 cases of patients were 3028, 336,684 and 63 respectively. The qualitative positive cases among these positive samples detected by ELISA were 2472, 269, 668, and 58. 603 samples in 684 cases of Anti-TP the quantitative positive samples were confirmed as positive by TPPA. Conclusion CMIA assay for quantification of pre-transfusion infection indicators could be used as early detec- tion of infection ＂window period＂ to reduce the missing rate. It would be very helpful in the early diagnosis and treatment of patients, and self-protection of healthcare workers.