核酸PCR法与酶联免疫吸附法在无偿献血血液标本检测中的价值分析

Value Analysis of Nucleic Acid PCR and Enzyme Linked Immunosorbent Assay in Detection of Samples from Blood Donation

目的探究核酸PCR法与酶联免疫吸附法在无偿献血血液标本检测中的应用价值。方法从2017年6月~2018年9月间我院接受的所有无偿献血者中随机抽取14 634名献血者血液样本进行检查。首先采取酶联免疫吸附法对血液样品中乙肝表面抗原(HBsAg)、丙肝病毒抗体(HCVAb)以及人类免疫缺陷病毒抗原抗体(HIVAg-Ab)进行检测,随后提取样本血液核酸,使用荧光定量PCR仪进行HIV、HCV和HBV病毒核酸扩增检验,分析两种不同检测方法的检测效率。结果HBV检测结果中核酸检测的阳性率为0.77%,高于酶联免疫吸附法检测的0.57%,差异有统计学意义(P<0.05);HCV检测结果中核酸检测的阳性率为0.63%,高于酶联免疫吸附法检测的0.44%,差异有统计学意义(P<0.05);HIV检测结果中核酸检测的阳性率为0.35%,略高于酶联免疫吸附法检测的0.25%,差异无统计学意义(P>0.05)。结论核酸PCR法对血液样品的检测精确度要高于酶联免疫吸附法,临床上应该结合两种方法使漏检率达到最低。

Objective To explore the application value of nucleic acid PCR and enzyme-linked immunosorbent assay in the detection of blood samples donated without compensation. Methods From June 2017 to September2018,14634 blood samples were randomly selected from all unpaid blood donors accepted by our hospital for examination. First of all,enzyme-linked immunosorbent assay was used to detect hepatitis B surface antigen(HBsAg),Hepatitis C virus antibody(HCVAb) and human immunodeficiency virus antigen antibody(HIVAg-Ab) in blood samples. Then the sample blood nucleic acid was extracted,and the amplification test of HIV,HCV and HBV virus nucleic acid was performed with the fluorescence quantitative PCR instrument to analyze the detection efficiency of the two different detection methods. Results The positive rate of nucleic acid detection in the HBV test results was 0.77%,which was higher than that of the enzyme-linked immunosorbent assay(0.57%). The difference was statistically significant(P<0.05). The positive rate of nucleic acid detection in HCV test results was0.63%,which was higher than that of enzyme-linked immunosorbent assay(0.44%). The difference was statistically significant(P<0.05). The positive rate of nucleic acid detection in HIV test results was 0.35%,which was slightly higher than that of enzyme-linked immunosorbent assay(0.25%). The difference was not statistically significant(P>0.05). Conclusion The accuracy of detection of blood samples by nucleic acid PCR method is higher than that of enzyme-linked immunosorbent assay. Clinical application should be combined with two methods to minimize the rate of missed detection.