35例无偿献血者的丙肝检测结果分析

The reflection of hepatitis C virus detection results of 35 cases blood donors

目的通过35例无偿献血者丙肝病毒的检测,思考如何通过提高丙肝的阳性检出率来增加输血的安全方法通过采用不同批号的同一厂家ELISA试剂对35例丙肝弱阳性的标本进行检测,并采用两种不同仪器同一批号的试剂对该批样本进行检测,最后对这一批样本采用RIBA进行最终的确认。结果 ELISA间接法中不同批号的试剂对这35例样本的检测阳性率分别为74.3%和45.7%,两者的检测结果配对卡方检验显示两者有显著差异;不同实验室采用同一批号的试剂检测这35例样本的阳性率分别为45.7%和8.6%;而NAT检测的阳性率为0,RIBA检测的阳性率为11.4%。其中,RIBA检出的4例阳性的复检结果均显示阳性,但同时显示复检存在一定的假阳性。结论为了增加输血的安全和降低假阳性率保留更多的献血者,建议实验室对新批号的试剂进行批间差异的比较,建立自己的判定规则,必要时可以对献血者进行追踪并做确证实验。严格控制NAT标本的储存和运输,保证样本的质量,提高HCV RNA的检出,最终提高血液的安全性。

Objective We reflect on how to increase the detection rate of Hepatitis C Virus and make sure the safety of transfusion by the hepatitis C virus detection of the thirty -five blood donors. Methods We use the different batches and the same reagents to detect the thirty-five weak positive hepatitis C virus samples, and then we use the different instruments and the same reagents to detect the thirty-five samples, at last we use the RIBA method to confirm the thirty- five samples.Results The positive rates of different batches of reagents in ELISA were 74.3 % and 45.7 % respectively, which shows a significant difference. The positive rates of different laboratories in the same batch reagent were 45.7 % and 8.6 % respectively. However, the positive rate of NAT was 0, the positive rate of RIBA was 11.4 %. Therefore, there are some false positive results in the detection of ELISA.Conclusions In order to increase the safety of transfusion and decrease the false positive rate to keep more and more blood donors, I suggest that the lab should compare the difference of the old and new batches ahead of time and set up rules. It' s necessary for the lab to track the blood donors and make some confirmatory tests for them. We must control storage and transportation of the blood samples strictly and make sure the quality of the blood samples to increase the true positive rate and improve the safety of blood.