抗凝与非抗凝血液标本对4项传染性指标酶联免疫吸附试验影响的研究

Study on the effects of anticoagulated and non-anticoagulated blood specimens on the results of ELISA detected four infectious indicators

目的观察并比较抗凝与非抗凝血液标本对4项传染性指标酶联免疫吸附试验结果的影响效果。方法选择2020年1月至2021年10月乌鲁木齐市中医医院采血的患者264例血液标本进行研究,均为全血标本。每份血液标本均使用非抗凝管留取静脉血,每支5 ml,并使用抗凝管(枸橼酸-枸橼酸钠)留取静脉血,每支2 ml。所有样本均接受离心处理,按照试剂说明书操作步骤手工加样后进行处理,获得最终的检测结果。结果经酶联免疫吸附试验初步检测,抗凝标本与非抗凝标本在乙型肝炎病毒(HBV)、人类免疫缺陷病毒(HIV)、梅毒螺旋体(TP)检测结果方面比较,差异有统计学意义(P<0.05)。264个样本标本中,有5例初次检测结果出现不一致,重复实验后结果显示,上述5例标本的复试结果趋于一致。初次检测0.8≤S/CO≤1的抗凝标本共有22份,对其进行抗凝与非抗凝血各一孔的双孔复试,22份标本经复试后,1份标本的结果为灰区,其余21份标本的结果为非反应性,最终的复试结果一致率为95.45%。结论在血液标本的检测中,与非抗凝血液标本比较,应用枸橼酸-枸橼酸钠抗凝血液标本会对4项传染性指标酶联免疫吸附试验检测结果产生一定的影响,导致一定假阳性的出现,但经复试后,可有效排除干扰。

Objective To observe and compare the effects of anticoagulated and non-anticoagulated blood specimens on the results of four infectious indicators detected by enzyme-linked immunosorbent assay(ELISA).Methods A total of 264 blood specimens were selected for the study,all of which were whole blood specimens collected from patients in Urumqi Hospital of Traditional Chinese Medicine from January 2020 to October 2021.Venous blood in each blood specimen was retained using non-anticoagulated tubes of 5 ml each and anticoagulated tubes(citrate-sodium citrate)of 2 ml each.All specimens were subjected to centrifugation and processed after the manual addition of specimens according to the operating procedures of the reagent instructions to obtain the final test results.Results The preliminary detection by ELISA showed that there were some differences between anticoagulated and non-anticoagulated blood specimens in terms of the test results of hepatitis B virus(HBV),human immunodeficiency virus(HIV)and treponema pallidum(TP),with statistically significant differences(P<0.05).Among the 264 specimens,there were 5 specimens with inconsistent initial test results,while the repeated test results of the above 5 specimens tended to be consistent.A total of 22 anticoagulated specimens with an initial test result of 0.8≤S/CO≤1 were double-well retested with one well each for anticoagulated and non-anticoagulated blood.The cumulative retest results revealed that after retesting 22 specimens,one specimen had the result distributed in the gray area,and the remaining 21 specimens had non-reactive results,with a final concordance rate of 95.45%.Conclusion Compared with non-anticoagulated blood specimens,the citrate-sodium citrate anticoagulated blood specimens can produce some influence on the results of ELISA detected four infectious indicators,leading to the appearance of certain false positives,but after retesting,the interference can be effectively excluded.