核酸检测与酶联免疫吸附试验在血液标本内乙肝病毒检测中的价值

目的研究核酸检测(NAT)、酶联免疫吸附试验(ELISA)在血液标准内乙型肝炎(乙肝)病毒(HBV)检测中的价值。方法20140例无偿献血者的血液标本为研究对象,先进行ELISA检测,对ELISA无反应性的标本再进行NAT,跟踪随访并分析检测结果。结果20140份血液标本中,ELISA检测双试剂阳性6份,单试剂阳性8份,双试剂阴性20126份。在双试剂阴性标本中,NAT检测呈阴性20111份,阳性15份,在确认阳性的15份标本中,对符合诊断条件的献血者进行追踪,ELISA阴性转化阳性3份,均在ELISA窗口期经过NAT检测确认,NAT检测中发现2份隐匿性HBV感染。结论NAT在临床检测中具有高灵敏度以及高特异性等优点,和ELISA相结合使用,一定程度上具有互补性,适用于血液检查中,能明显减少误诊情况发生,减少窗口期,对输血安全有重要意义。

Value of nucleic acid testing and enzyme-linked immunosorbent assay in detection of hepatitis B virus in blood specimen

Objective To study the value of nucleic acid testing(NAT)and enzyme-linked immunosorbent assay(ELISA)in detection of hepatitis B virus(HBV)in blood specimen.Methods Blood specimens from 20140 unpaid blood donors were used for the study,and ELISA was performed first,followed by NAT for ELISA non-reactive specimens,and the test results were followed up and analyzed.Results Among the 20140 blood specimens tested,6 specimens were positive for double reagents,8 specimens were positive for single reagents,and 20126 specimens were negative for double reagents by ELISA.Among the double-reagentnegative specimens,20111 specimens were negative and 15 specimens were positive by NAT testing.Among the 15 confirmed positive samples,the blood donors meeting the diagnostic criteria were followed up,and 3 cases with positive ELISA negative conversion were confirmed by NAT testing in the ELISA window period.2 cases of occult HBV infection were found in NAT testing.Conclusion NAT testing has the advantages of high sensitivity and specificity in clinical detection,and it is complementary to ELISA to a certain extent.It is suitable for blood examination,and can significantly reduce the occurrence of misdiagnosis and reduce the window period,which is of great significance to the safety of blood transfusion.