2018—2022年山东省采集脐带血产妇血液检测结果分析

Analysis of the Results of Blood Tests in Pregnant Women With Umbilical Cord Blood Collected in Shandong Province From 2018 to 2022

目的 对山东省2018年1月—2022年12月采集脐带血产妇的血液检测结果进行回顾性分析,为本省内采集脐带血的工作提供科学依据,确保脐带血的安全入库,以便更好地服务于临床。方法 选择2018年1月—2022年12月山东省561 423名采集脐带血的产妇静脉血为研究对象,采用酶联免疫吸附法(enzyme linked immunosorbent assay,ELISA)检测乙肝表面抗原(hepatitis B surface antigen,HBsAg)、丙肝抗体(anit hcv hcvab,抗-HCV)、梅毒螺旋体抗体(treponema pallidum antibody,抗-TP)、人类免疫缺陷病毒抗体(human immunodeficiency virus antibody,抗-HIV)、巨细胞病毒抗体(cytomegalovirus antibody,HCMV-IgM),将抗-HIV筛查有反应性样本送至济南市疾控中心进行抗体确证实验;酶免无反应性的样本采用核酸检测技术(nucleic acid testing,NAT)检测乙肝病毒DNA(hepatitis b virus DNA,HBV DNA),丙肝病毒RNA(hepatitis c virus RNA,HCV RNA)和人类免疫缺陷病毒RNA(human immunodeficiency virus RNA,HIV-1 RNA),对检测结果进行统计分析。结果2018—2022年酶免血清学检测总不合格率为3.052%(17135/561423),年度间差异有统计学意义(P <0.001)。HBsAg阳性率为2.218%(12451/561423),年度间差异有统计学意义(P<0.001)。产妇HBsAg阳性,同时脐血HBsAg阳性率为1.791%(223/12451),年度间差异有统计学意义(P<0.001)。抗TP阳性率为0.160%(900/561423),年度间差异有统计学意义(P <0.001)。抗-HIV筛查阳性率0.046%(257/561423),年度间差异有统计学意义(P<0.001)。经济南市疾控中心确认抗-HIV抗体阳性1例;HCMV-IgM阳性率为0.573%(3216/561423),年度间差异有统计学意义(P <0.001)。抗-HCV阳性率为0.055%(311/561423),年度间差异无统计学意义(P=0.119)。HBVDNA阳性率为0.030%(150/495940),年度间差异无统计学意义(P=0.887)。HCVRNA和HIV-1RNA均为阴性。结论 乙肝病毒和巨细胞病毒是采集脐带血产妇的主要传染病毒,乙肝病毒存在一定比例的母婴传播。对采集脐带血的产妇进行传染病检测。能够降低脐带血的传染风险,提高脐带血应用的安全性。

Objective To retrospectively analyze the blood test results of pregnant women with umbilical cord blood collected in Shandong Province from 2018 to 2022,so as to provide a scientific basis for the collection of umbilical cord blood in Shandong Province,ensure safe storage for cord blood and better serve clinical practice.Methods From January 2018 to December 2022,the venous blood of 561 423 parturients who collected umbilical cord blood in Shandong Province was selected as the research object,hepatitis B surface antigen(HBsAg),anit hcv hcvab(anti-HCV),treponema pallidum antibodyan(antiTP),human immunodeficiency virus antibody(anti-HIV),cytomegalovirus antibody(HCMV-IgM) were detected by enzymelinked immunosorbent assay(ELISA).The positive samples of antiHIV screening were sent to Ji′nan CDC for antibody confirmation test.Samples with no reactivity during enzymolinked immunoassay were tested by the nucleic acid assay(NAT) for hepatitis b virus DNA(HBV DNA),hepatitis c virus RNA(HCV RNA),human immunodeficiency virus RNA(HIV-1 RNA),and the test results were statistically analyzed.Results From 2018 to 2022,the total unqualified rate of ELISA serological test was 3.052%(17 135/561 423),and there was significant difference between years(P<0.001).The positive rate of HBsAg was 2.218%(12 451/561 423),and there was significant difference between years(P<0.001).Maternal HBsAg was positive,and the positive rate of HBsAg in correlative umbilical cord blood was 1.791%(223/12 451),with significant difference between years(P<0.001).The positive rate of anti-TP was 0.160%(900/561 423) with a significant difference between years(P<0.001).The positive HIV test rate was 0.046%(257/561 423),and there was a large difference between years(P<0.001).One case confirmed positive by the CDC of Jinan.The positive rate of HCMV-IgM was 0.573%(3 216/561 423),and there was a large variance between years(P<0.001).The positive anti-CHV rate was 0.055%(311/561423) and there was no statistical difference between years(P =0.119).The positive HBV DNA was 0.030%(150/495 940) and there was no statistical difference in years(P = 0.887).HCV RNA and HIV-1 RNA tested negative.Conclusion Hepatitis B virus and cytomegalovirus are the major infectious viruses among pregnant women who collect umbilical cord blood.There is a certain percentage of transmission between mother and child of hepatitis B virus.Testing for infectious diseases in pregnant women who collect cord blood can reduce the risk of transmission of cord blood and improve the safety of the cord blood application.