血液筛查ALT临界值的变更后检验结果分析

Analysis of blood screening results before and after changing critical value of ALT

目的：通过分析对比丙氨酸氨基转移酶（ALT）临界值调整后40-50 U/L 和大于50 U/L 献血者的血液检测结果,观察降低血液报废率效果和探讨 ALT 异常与 HBV 和 HCV 感染的相关性。方法分析青岛市中心血站2013-2014年2656例ALT＆gt;40 U/L 的无偿献血者的 HBV 和 HCV 血清学和核酸检测（NAT）结果并进行相关性研究。结果ALT 在40-50 U/L 者共1771例（66.68%）,其中6例 HBsAg ELISA（＋）,NAT（＋）2例,NAT（-）4例,8例抗-HCV 抗体 ELISA（＋）样本中,NAT （＋）4例,NAT（-）3例,1例 TP 阳性未做 NAT。ALT＆gt;50 U/L 的885例献血者中,HBsAg 反应性者5例,抗-HCV 抗体反应性者7例,全无反应性者873例。相关性统计数据表明：ALT 与 HBV 差异无统计学意义（P〈0.05）,ALT 与 HCV 差异有统计学意义（P〉0.05）。结论ALT 在40-50 U/L 的献血者的比例远远高于50 U/L 以上的献血者,调整临界值后大大降低了血液报废率,ALT 升高与 HBV 发生存在相关性而与 HCV 的发生不存在相关性。

Objective To analyze the blood screening results after adjustment of critical value 40 to 50 U/L and to observe the effect of reducing blood scrap rate and to discuss the correlation between ALT and HBV,HCV infection.Methods We screened 2656 blood donors （ALT〉40 U/L）by serological and nucleic acid amplification testing（NAT）in Qingdao blood center from 2013 to 2014,and conducted the correlation analysis by chi square test.Results 1 771 cases （66.68%）were ALT 40-50 U/L,including 6 cases of HBsAg ELISA （＋）,2 cases NAT （＋）,4 cases NAT（-）.In the 8 cases of anti-HCV ELISA （＋）samples,4 cases NAT （＋）,3 cases NAT （-）,1 case with positive TP without NAT result.In 885 blood donors with ALT＆gt;50 U/L,5 cases were HBsAg-reactive,7 cases were anti-HCV-reactive,and 873 cases were negative.Related statistics showed that there was no significant difference between ALT and HBV infection （P〈0.05）,but significant difference was found between ALT and HCV infection （P〉0.05）.Conclusion The proportion of blood donors with ALT 40-50 U/L is much higher than that with ALT〉50 U/L donors.Adjustment of the critical value greatly reduces blood scrap rate.Elevated ALT is associated with the infection of HBV but not with HCV.