酶联免疫吸附试验检测艾滋病病毒抗体的失控原因分析

Analysis of the Causes of Loss of Control of HIV Antibody by Enzyme Linked Immunosorbent Assay

目的评价酶联免疫吸附试验对艾滋病病毒抗体检测失控的原因,以期待为临床检验工作提供科学依据。方法选择2018年5月至2019年10月来我中心进行艾滋病病毒抗体筛查的34例疑似艾滋病患者,对所有调查对象选择采用酶联免疫吸附试验进行检测,检验过程中对受试者进行静脉血采集,常规进行艾滋病病毒抗体的检查,并将蛋白印迹试验作为参照,对诊断结果进行统计分析,并且研究酶联免疫吸附试验检测艾滋病病毒抗体失控的原因。结果蛋白印记试验检验33例被确诊为艾滋病患者,占97.06%;对所有患者应用酶联免疫吸附试验进行艾滋病病毒抗体检测,诊断为艾滋病患者30例,诊断的符合率为90.91%,敏感度为96.67%,特异度为75.00%,准确度为94.12%;对所有调查对象进行追溯分析,在误诊的3例患者当中,存在标本污染、溶血标本、血液标本处理不当各1例,标本处理不当的主要原因为浓度较高的非特异性免疫球蛋白影响而出现假阳性,还有1例患者标本当中含有补体险些导致漏诊出现,但经过仔细分析对比而避免了相关状况的发生,也提示临床应对此状况予以重视。结论临床对艾滋病病毒抗体通过酶联吸附试验进行检验能够具有较高的诊断效率,而导致检验失控的原因来自于多个方面,综合做好各个方面的质控工作能有效确保酶联免疫吸附试验对艾滋病诊断的效率提高。

Objective To evaluate the reasons for the loss of control of HIV antibody detection by enzyme-linked immunosorbent assay(ELISA),and to provide scientific evidence for clinical laboratory work.Methods The time of investigation was selected from May 2018 to October 2019.The selected respondents were 34 suspected AIDS patients who were sent to our center for HIV antibody screening during this period.All subjects were selected for ELISA.The test was carried out.The venous blood was collected from the subjects during the test.The HIV antibody was routinely examined,and the Western blot test was used as a reference.The diagnostic results were statistically analyzed,and the enzyme-linked immunosorbent assay(ELISA)was used to detect the loss of HIV antibody's reason.Results A total of 33 patients with AIDS were diagnosed as AIDS patients,accounting for 97.06%.All patients were tested for HIV antibody by enzyme-linked immunosorbent assay(ELISA),and 30 patients with AIDS were diagnosed.The coincidence rate was 90.91%.The sensitivity was 96.67%,specificity was 75.00%,and accuracy was 94.12%.Retrospective analysis was performed on all subjects.Among the 3 patients misdiagnosed,there were specimen contamination,hemolysis specimens,and improper treatment of blood specimens.The specimens were improperly handled.The main reason is the false positives caused by the higher concentration of non-specific immunoglobulins,and the lack of complement in one patient's specimens leads to missed diagnosis.However,after careful analysis and comparison,the related conditions are avoided.The situation is taken seriously.Conclusion The clinical diagnosis of HIV antibodies by enzyme-linked immunosorbent assay can have higher diagnostic efficiency,and the reasons for the out-of-control test come from many aspects.Comprehensive quality control work can effectively ensure the enzyme-linked immunosorbent assay.Improve the efficiency of AIDS diagnosis.