潍坊地区献血人群经血传播疾病流行病学研究

发布时间：2018-03-23 18:27

本文选题：献血人群　切入点：流行病学　出处：《青岛大学》2017年硕士论文

【摘要】：目的了解潍坊地区无偿献血人群经血传播疾病(乙型病毒性肝炎、丙型病毒性肝炎、艾滋病、梅毒)的感染及合并感染情况,为献血人群的选择和招募安全血源的策略提供理论依据;并对两套检验体系(ELISA(酶联免疫吸附测定,Enzyme Linked Immunosorbent Assay)、NAT(核酸检测,Nucleic Acid Test))的结果差别进行统计分析,探讨现行实验条件下献血者标本的实验室检测方案。方法对潍坊市2011年1月-2015年12月共423412位志愿献血者(18~55周岁)进行HBs Ag(HBV DNA)、抗-HCV(HCV RNA)、HIV Ag/Ab(HIV RNA)、抗-TP等感染标志物的检验(每个项目两种酶免试剂同步检测),结合无偿献血者的个人资料,对无偿献血者按不同献血年份、性别、年龄区间、职业、学历等组别进行划分,得出几种经血传播疾病检测指标的感染和合并感染情况,分析其流行病学特征。同时对2015年3月-9月间(2015年起ELISA检测不合格样本进行HBV DNA、HCV RNA、HIV RNA混样模式检测)献血者HBs Ag、抗-HCV、HIV Ag/Ab实验不合格样本(80例、110例、90例)分别进行HBV DNA、HCV RNA、HIV RNA单人份重复测试,并分析两种检测方法的相关性,探讨实验室血液检测策略。结果(1)潍坊市2011—2015年无偿献血者HBs Ag(HBV DNA)、抗-HCV(HCV RNA)、HIV Ag/Ab(HIV RNA)、抗-TP检测不合格率分别为0.36%、0.31%、0.19%、0.55%。(2)不同年份组间、不同年龄区间组间、不同职业组间、不同学历组间HBs Ag(HBV DNA)、抗-HCV(HCV RNA)、HIV Ag/Ab(HIV RNA)、抗-TP检验结果不合格率的差别均有统计学意义(P0.05);不同性别间HBs Ag(HBV DNA)、抗-HCV(HCV RNA)、HIV Ag/Ab(HIV RNA)检测不合格率差异均有统计学意义(P0.05),而抗-TP不合格率无统计学意义(P0.05)。(3)合并感染中,HBV+HCV、HBV+HIV、HBV+TP、HCV+HIV、HCV+TP、HIV+TP合并阳性分别为19例、11例、21例、5例、16例、37例,HBV+HIV+TP合并阳性1例,以TP合并其他感染性指标人数最多(75/110),又以TP与HIV合并感染最多(37/75);合并感染者的年龄区间、性别、学历、职业组间差别均有统计学意义(P0.05)。(4)84577份献血者HBs Ag、抗-HCV、HIV Ag/Ab检测阴性标本中,检出HBV DNA 16例,HCV RNA 0例、HIV RNA 3例;HBs Ag、抗-HCV、HIV Ag/Ab酶免检测结果阳性标本中,HBV DNA、HCV RNA、HIV RNA单人份复测阳性率分别为40%(32/80)、20.9%(23/110)、22.2%(20/90),且NAT不合格标本以ELISA两种试剂均阳性为主(73/75)。结论(1)潍坊市无偿献血者感染性指标中,HBV感染率近年呈下降趋势,HCV、HIV、TP感染率呈升高趋势,且不同性别、年龄区间、职业、学历间感染率有差别。(2)献血者有合并感染状况,以TP合并HIV感染为主。(3)初筛可降低感染性指标的不合格率,可增加梅毒快速初筛项目。(4)核酸检测可缩短病毒感染检测的“窗口期”,与ELISA检测方法互为补充。(5)可考虑应用一种酶免疫方法检测加核酸混样检测模式。
[Abstract]:Objective to investigate the infection and co-infection of blood-borne diseases (viral hepatitis B, hepatitis C, AIDS, syphilis) among unpaid blood donors in Weifang area. To provide a theoretical basis for the selection of blood donors and the strategy of recruiting safe blood sources, and to analyze the difference between the results of two test systems, Enzyme Linked Immunosorbent Assayama (nucleic Acid Test). To probe into the laboratory detection scheme of blood donor specimen under the present experimental conditions. Methods 423412 volunteer blood donors from January 2011 to December 2015 in Weifang City were tested for HBs Ag(HBV DNA, anti-HCV Ag(HBV RNA, anti-HIV Ag/Ab(HIV RNA, anti-TP and other infection markers. (two enzyme immunoassay kits for each item, combined with the personal data of the unpaid blood donor, According to different blood donation years, sex, age range, occupation, educational background and other groups of unpaid blood donors, the infection and co-infection of several blood transmission diseases were obtained. At the same time, from March to September 2015, the blood donors of HBs Agin and the unqualified samples of anti-HCV Ag/Ab test were tested by HBs Agand 90 cases of anti-HCV Ag/Ab test, respectively, from March to September of 2015 (from 2015 to 2015 when the unqualified ELISA samples were tested for HBV DNA HCV RNA RNA-HIV RNA mixed sample model) and 80 unqualified samples for anti-HCV Ag/Ab test. HBV DNA-HCV RNA RNA HBV RNA single copy repeat test, The correlation between the two methods was analyzed and the laboratory blood test strategy was discussed. Results 1) in Weifang City from 2011 to 2015, the unqualified rates of HBs Ag(HBV DNA, anti-HCV Ag(HBV RNA and anti-HCV Ag/Ab(HIV were 0.360.31 0.19 0.55.2. among different age groups, the unqualified rates were 0.36%, 0.31% and 0.55%, respectively, among the groups of different ages, the unqualified rate of anti-HCV detection was 0.360.31 (0.19) 0.55.2in Weifang City, the unqualified rate of anti-HCV Ag(HBV was 0.360.31 0.190.55.2in different years, Between different occupational groups, There were significant differences in the unqualified rates of HBs Ag(HBV DNA, anti-HCV Ag(HBV and anti-HCV Ag/Ab(HIV RNAs and anti-TP among different education groups, and there were significant differences in the unqualified rates of HBs Ag(HBV DNA and anti-HCV HBs HBs Ag/Ab(HIV among different genders (P0.05and anti-TP). There was no significant difference in the rate of HIV TP co-infection. The positive rate of HIV TP was 19 cases (11 cases), 5 cases (16 cases) and 37 cases (37 cases) were positive for HBV HIV TP, respectively, in 19 cases (11 cases), 16 cases (16 cases) and 37 cases (1 case). TP combined with other infectious indexes had the highest number of people (75 / 110), and TP and HIV had the most co-infection (37 / 75). There were significant differences in the age range, sex, educational background, and occupational groups among the infected individuals. There were significant differences in the age range, sex, educational background, and occupational groups of 84577 blood donors with HBs Agand anti-HCV Ag/Ab negative samples. 16 cases of HBV DNA, 0 cases of RNA and 3 cases of HBs Ag.Among the positive specimens of anti-HCV DNA Ag/Ab Ag/Ab, the repeat positive rate of single HIV RNA was 4032 / 80% 20. 9% 20. 9% 20. 2% 20. 2% and NAT substandard samples were mainly positive for ELISA and 73% 75%. Conclusion: 1) in Weifang, the positive rate is 73.75%. The infection rate of hepatitis B virus (HBV) in blood donors was decreasing in recent years. The infection rate of HIV / TP was increasing. The infection rate of blood donors was different among sex, age range, occupation and educational background. The primary screening of TP combined with HIV infection could reduce the unqualified rate of infectious index. Nucleic acid detection can shorten the window period of virus infection detection. It is complementary to ELISA detection method. It can be considered to use an enzyme immunoassay plus nucleic acid mixed sample detection mode.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R181.3

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