核酸检测系统联检与鉴别检测结果不一致原因分析

发布时间：2018-03-12 06:35

本文选题：核酸联检　切入点：核酸鉴别检测　出处：《中国输血杂志》2016年08期 　论文类型：期刊论文

【摘要】：目的探究献血者常规血液筛查过程中核酸检测系统HBV、HCV、HIV联测(NAT联检)反应性而鉴别检测非反应性结果的原因。方法收集2010年11月-2012年3月本中心献血者常规血液筛查过程中NAT联检单反应性且和鉴别检测结果不一致的献血者标本504(人)份。采用化学发光法检测其HBsAg、抗-HBs、抗-HBc、HBe Ag及抗-HBe(乙肝5项),采用荧光定量PCR技术(Taq Man核酸检测系统)对这些标本再次做NAT检测,以确定其感染的血清学和分子生物学状态;同时回溯其中的40名检测结果不一致献血者,做血清学乙肝标志物及HBV DNA、HCV RNA和HIV RNA追踪检测。结果常规血液筛查过程中核酸联检单反应性且联检和鉴别检测结果不一致标本中,72.82%(367/504)呈乙肝相关抗体或抗原反应性,13.35%(49/367)的标本在荧光定量PCR检测中呈现HBV反应性。追踪检测结果显示,22.50%(9/40)可能为初次联检假阳性标本,其余77.50%(31/40)均为乙肝隐匿型感染(OBI)均未出现HCV RNA、HIV RNA反应性结果。结论 OBI是导致献血者血液NAT联检反应性而鉴别非反应性结果不一致的1个主要原因;基于血液安全性和检测效率的考虑,该部分血液应废弃,但对于血清学乙肝5项检测和NAT联检重复检测非反应性的献血者,应作检测追踪并考虑其再次献血的可能性。
[Abstract]:Objective to investigate the causes of nonreactivity in the nucleic acid detection system (HBV / HCV / HIV / Nat) in the routine blood screening of blood donors. Methods from November 2010 to March 2012, the normal blood sieve of blood donors in our center was collected. 504 (human) blood donors with NAT reactivity and inconsistent with the results of identification were detected by chemiluminescence assay for HBsAg, anti-HBs, anti-HBcnHBe Ag and anti--HBe5 (HB5), Taq Man nucleic acid was detected by fluorescence quantitative PCR technique. The NAT test is done again on these specimens. To determine the serological and molecular biological status of their infection, and to trace back to 40 of the blood donors whose results were inconsistent. The serological markers of hepatitis B and HBV DNA-HCV RNA and HIV RNA were followed up. Results in the routine blood screening process, the reactivity of nucleic acid monosorph was 72.82% or antigenic reactivity. The samples of 13.35% and 49% 367 showed HBV reactivity in the fluorescence quantitative PCR test. The results of the tracing tests showed that the samples were probably the first false positive samples. The other 77.50% ~ (31 / 40) were not HCV RNA-HIV RNA reactivity. Conclusion OBI is one of the main reasons that lead to the blood NAT reactivity of blood donors and the difference in identifying non-reactivity results. Considering the safety and efficiency of blood, this part of blood should be abandoned, but for the non-reactive blood donors whose serological hepatitis B test and NAT repeated detection should be followed up and the possibility of blood donation should be considered.
【作者单位】：北京市红十字血液中心;
【分类号】：R446.6

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