输血患者丙肝标志物的合理检测程序探索

Study on the reasonable detection procedure of hepatitis C markers in transfusion patients

目的分析丙型肝炎病毒标志物不同组合检测模式在输血患者中的应用价值,探索输血患者丙肝标志物的合理检测程序。方法选择临床输血前患者的血清1280例,分为总体组(Ⅰ组)和肝功能异常组(Ⅱ组)。Ⅰ组(1280例)行输血前8项+HCV-cAg及ALT、ADA、AST、GGT等肝功能测定;Ⅱ组:从Ⅰ组中选择肝功能异常,同时抗-HCV阴性且排除乙肝的患者49例,回顾分析HCV-cAg的检测总量与漏检率。结果Ⅰ组:抗-HCV+HCV-cAg联合检测模式阳性率为2.34%,抗-HCV阴性中HCV-cAg阳性率为0.63%;Ⅱ组:与Ⅰ组比较,减少了96.2%HCV-Ag的检测,丙肝的漏检率为0.31%。结论对临床输血患者丙型肝炎病毒感染的筛查,可先行输血前8项及ADA、AST等肝功能测定,根据这些结果再选择是否进行HCV-cAg或HCV-RNA测定,此模式不仅能节省大量的医疗费用及人力成本,而且也能发现一定的"窗口期"丙肝患者,漏检率非常低,值得推广应用。

Objective To analyze the application value of different combination detection models of hepatitis C virus markers in transfusion patients,and to explore the reasonable detection procedure of hepatitis C virus markers in blood transfusion patients.Methods 1280 serum of patients before transfusion were selected and divided into two groups,total group(GroupⅠ)and abnormal liver function group(GroupⅡ).8 items of HCV-cAg and the liver function such as ALT,ADA,AST,GGT etc.of the serum before transfusion in GroupⅠ(1280 cases)were measured;GroupⅡ:49 patients with abnormal liver function,negative for anti-HCV and excluded hepatitis B were selected from GroupⅠ,the total amount of HCV-cAg and missed detection rate were retrospective analyzed.Results GroupⅠ:the positive rate of anti-HCV combined HCV-cAg detection mode was 2.34%.The positive rate of HCV-cAg in negative anti-HCV was 0.63%.GroupⅡ:compared with GroupⅠ,the detection of HCV-Ag was reduced by 96.2%,and the missed detection rate of hepatitis C was 0.31%.Conclusion The screening of hepatitis C virus infection in patients with clinical transfusion can be preceded by the determination of liver function such as 8 items before transfusion and ADA,AST,etc.On the basis of these results,whether to do the determination of HCV-cAg or HCV-RNA were selected.This model not only can save a lot of medical expenses and manpower costs,but also can find hepatitis C patients of"window period",the missed rate is very low,and being worthy popularizing and applying.